Skin cancer

The development of malignant neoplasia of the skin prevails in the light-skinned population, in particular - in blue-eyed and gray-eyed people with blond hair, redheads, as they are prone to sunburn and freckles. Women and men are affected with equal frequency, dark-skinned people are rarely affected.

Skin cancer: causes

Among the factors that stimulate the occurrence of skin cancer, the following are distinguished:

• Prolonged and intense exposure to ultraviolet radiation, as skin cancer manifests itself on open areas of the body that are prone to sun exposure.
• Various substances with local application that have carcinogenic properties.
• Radioactive radiation, including radiotherapeutic measures.
• Injuries of a mechanical and chemical nature, on the background of which scars appear. They can become a substrate for the development of an oncoprocess.
• Hereditary variants of the disease.
• The skin is constantly exposed to aggressive chemicals, including household chemicals.
• Change in hormonal homeostasis.

Precancerous conditions of the skin

Precancerous skin conditions are divided into two main groups: optional, the risk of abuse of which is minimal, and mandatory — precancers, which, in the end, will definitely become cancers.

Facultative precancerous conditions include:

• Cutaneous horn - a cone-shaped neoplasm protruding above the skin level. It can have dimensions from several millimeters to centimeters. The surface is thick, horny, brown in color, the base is soft. It is located mainly on the skin of the face, auricles, hairy part of the head, less often on the limbs and trunk. It is treated surgically.
• Keratosis is a skin pathology of a dystrophic nature, manifested by gray-yellow keratinized cells of various thicknesses. When trying to tear off these formations, drops of blood may appear. They are localized on bald areas of the head and on the skin of the face. Older men are mostly affected, but it can also appear at a young age. It is treated with the help of surgical excision or electrocoagulation.
• Keratoacanthoma - a tumor that has the appearance of a dense hemispherical node with an ulcer in the center, filled with gray-black detritus. As a variant of development, there can be a hard thorn of a yellowish shade, which is easily separated from the skin, leaving a small depression covered with an apparently unchanged epithelium. The surface of the tumor is not prone to bleeding, and may eventually disappear on its own. It is treated by cryodestruction or electrocoagulation.
• A birthmark or nevus is a cluster of cells containing melanin in different layers of tissue. They appear in childhood, stop growing in adolescence, and may become depigmented in old age.
• Ota nevus - round-oval formations with more or less pronounced pigmentation. Can develop in two directions: fibrosis – regression process; proliferation - growth.
• Giant pigment nevus – congenital skin pathology. There are areas of pigmentation, the size of the palm and more, the localization is diverse. Color - from light to dark brown, may have areas of ulcers, papillomas and increased hair growth. Causes serious cosmetic defects.

Obligatory neoplasms include:

• Bowen's dyskeratosis — spots of various shapes, with characteristic polycyclic contours. They have crusts on their surface that are difficult to separate, under which a smooth or papillary part is found. They are mainly localized on the skin of the body. The prognosis if not detected is unfavorable, because skin cancer begins almost immediately with the progression of the disease. They are treated with surgical methods.
• Pigmented xeroderma is a hereditary pathological condition in which the sensitivity of the skin to ultraviolet light increases 10-12 times. Appears in early childhood, after the first contact with solar radiation. Clinically: the skin swells, acquiring a red tint. Redness is later replaced by scattered, unprotected parts of the body with pigment spots of a rounded shape. They are replaced by atrophic areas of the skin of a light-white shade, through which telangiectasias - excessively expanded capillaries - shine through. Gradually, areas with ulcers and warty growths develop on the atrophied skin, which will later become cancer. The neoplasm, which arose against the background of pigmented xeroderma, develops very slowly and is quite sensitive to the use of radiation therapy. Such consequences are prevented with the help of photoprotective agents.
• Dubray's precancerous melanosis has the appearance of a pigment spot with irregular brown outlines. Its surface may be atrophic, keratotic or covered with papillomas in places. The size is the most diverse, they are found mainly on the face, neck, external genitalia of women. It often turns into melanoma. In order to suspect skin cancer in time, a photo (initial stage) can be found in specialized atlases or open sources.
• Keir's disease is a disease that affects the epithelium of the head of the penis. A neoplasm of a rich red color has clearly visible borders. In a third of cases, transformation into a malignant tumor is observed. Treatment is surgical.

Skin cancer: types

Malignant skin neoplasms are divided into several groups, according to their cellular structure and clinical manifestations. Basically, two classifications are used - clinical and morphological.

Clinical classification

The following are distinguished by clinical signs:

• Superficial skin cancer – the signs are obvious, the neoplasia is manifested by white nodules of a dense consistency, yellow or gray-white in color. They are located at the same level as the skin, sometimes a little higher. The surface can be both smooth and rough. Over time, the central part of the tumor may begin to get wet, and a crusted ulcer appears in its place. Adjacent areas take on a pink hue, signs of the inflammatory process are observed. The ulcer may bleed periodically.
• Infiltrative skin cancer - the first signs are manifested by the presence of mobile, bumpy nodules of a dense consistency, covered by an unchanged epidermis. Over time, the nodules become covered with ulcers and penetrate into the underlying tissue structures. This is a less favorable form according to forecasts, which metastasizes early.
• Papillary skin cancer is characterized by hilly outgrowths that grow in two directions at once — partly in the depth of the lower tissues, partly towards the surface of the skin.

Morphological classification

According to the morphological classification, the following are distinguished:

Basal cell skin cancer occurs in old age, mainly located on the skin of the face. The following varieties are distinguished:

• Exophytic form - grows in the form of a solid nodule that merges with the surface of the skin or protrudes above it on a wide base. The skin covering the node is thin, shiny or matte. Later, deep cracks may appear around the node, which have purulent-bloody secretions and have an unpleasant aroma. The development of this cancer takes place slowly, the process of ulcers (abscesses) gradually appears. Ulcer with a dense bottom, painless. Metastasis is not typical.
• Surface form. This skin cancer (basal cell carcinoma) develops as a plaque with very characteristic edges: clear, waxy-shiny. The size of the focus ranges from 0.1 to 3 cm, the contours are irregular or rounded, brownish-red shade. Crusts, telangiectasias, and erosive changes can be found on the surface of the plaque. It grows slowly, the prognosis of most patients is favorable.
• The ulcerative form develops against the background of superficial or exophytic basal cell carcinoma. It is characterized by the destruction of surrounding tissue structures and bones in the process of growth. The ulcer has irregular or rounded contours, the bottom is red-brown, sebaceous, with a gray-black crust, the edges are ridged.
• The scar form takes the form of a flat and dense scar of a gray-pink shade, located below the level of the skin. The edges of the focus are clear, elevated, on the periphery there may be several erosions with crusts of a pinkish-brown shade, one part of which is later cut off, and the other moves to the surface of healthy areas of the skin.

Squamous skin cancer at the very beginning of its development is represented by a node of a yellow-dirty hue, covered with yellow crusts that bleed at the slightest touch. Later, an ulcer defect with an uneven bottom forms under the node. Cancer of the skin of the face, auricles, external genital organs and limbs is often detected. Neoplasia gradually penetrates deep into the tissues and produces regional metastases. In the case of extensive damage to the skin, infection is possible, as a result of which a pain syndrome will develop. If you want to understand what squamous cell skin cancer looks like, a photo (initial stage) can be found on various Internet resources or ask your doctor.

Melanoma is a pigment formation of the skin covering 10% of all oncological processes of the skin. Recognized as the most malignant tumor of the entire body. It can be cancer of the scalp and other parts of the body, possible development in the eye, intestinal mucosa and even the esophagus. The following forms are distinguished:

• Superficial creeping melanoma. Neoplasia is located in the superficial layers of the dermis, it is a flat formation that protrudes above the skin surface.
• Nodular melanoma. A tumor that quickly affects the layers of the skin. It has a nodular shape, sometimes it looks like a polyp on a leg, the color of the formation is blue.
• Acrolentiginous form. The neoplasia is black in color (may not be pigmented), with uneven contours, grows in the superficial layers of the dermis, and is often localized on the feet and palms.
• Malignant lentiginous form. The so-called "melanotic swallows". Nodules in a couple of millimeters from yellow to black shades. Growth is slow.

Cancer of skin appendages

Sebaceous, sweat gland and hair follicle cancer should be highlighted separately:

• Hydrocarcinoma is a tumor of the sweat glands in the form of a single nodule located above the skin level. It most often develops in elderly patients. Skin cancer is localized on the nose, scalp, limbs and face. Grows slowly, can be covered with ulcerative defects.
• Mucinous carcinoma is a neoplasm of the sweat gland, located in the armpits. It is a smooth dense node of a bluish shade. It metastasizes very rarely.
• Adenocarcinoma of the sebaceous glands - develops in the elderly, has a lobular structure, and lobes of different shapes and sizes. Cancer of the skin of the nose, face and scalp is determined in the vast majority of cases. The current is aggressive.
• Malignant tricholemmoma is a tumor of the hair follicle, it can look like a plaque, papule or nodule. It often erupts, can metastasize.

Skin cancer: stages

Phases of the development of the oncoprocess in the skin can be divided into 4 stages:

• The first is characterized by the fact that the cancer does not exceed 2 cm in diameter. Although it reaches the lower layers of the epidermis, it does not penetrate deep and does not metastasize. To find out what skin cancer looks like (initial stage), the photo can be viewed in specialized medical sources.
• In the second phase of the disease, the tumor process reaches 4 cm, but still does not penetrate into the lymphatic vessels, painful sensations appear.
• In the third stage, the spread of regenerated cells through the lymphatic system and their deposition in local lymph nodes occurs.
• In the fourth stage, the tumor process reaches distant organs, and the tumor itself becomes large, covered with ulcers and penetrates into the tissues up to the bones.

Skin cancer: symptoms

The initial stages do not have any specific symptoms. However, some signs will give a partial answer to how to identify skin cancer:

• Some unusual elements appeared on the roofs that you have not seen before – nodules, plaques.
• Appearance of cracks, wounds for no apparent reason around neoplasms.
• An old or new education grows in size, starts to hurt or itch, brings some discomfort.
• The mole has changed its usual shape, its contours are asymmetrical, its size has increased.
• The nevus changed color, became uneven, spotted, papillomas, ulcers, crusts appeared on its surface.
• On neoplasms of any age, areas with abscesses began to appear.
• When palpating the skin formation, you can feel compactions leading deep into the tissues.

Skin cancer: diagnosis

The main diagnostic measures to confirm skin cancer include:

• Dermatoscopy - visual assessment of the tumor, approached with the help of special magnifying glasses.
• Thermography – measuring the temperature of the neoplasm.
• A smear is an impression. A method in which a slide is applied to a crusted ulcer with light pressure. Several rocks and different areas of the supposed tumor are used. After that, the collected prints are examined using microscopy.
• Scrape. With the help of a special wooden spatula, a few contents are scraped from the bottom of the surface ulcer and the material is transferred to a glass slide for further study.
• Biopsy. With a puncture type, cellular material is taken from the depth of the formation using a needle with a syringe. In the case of the excisional option, which is possible when the size of the education is small, its excision is performed within the limits of the tissues not prone to the process, with further examination of the remote area. With the incisional variant, a large neoplasm is removed in a wedge-like fashion, capturing healthy tissue structures.
• Visualize the methods necessary to clarify and check the spread of the oncoprocess. These include: ultrasound screening, computer tomography examination.

Diagnosis of melanoma is prohibited by biopsy, as there is a high risk of cancer cells spreading to other tissues of the body.

How to treat skin cancer

Three main therapeutic methods are used: operative method, radiotherapy and treatment with special chemical drugs. The first two methods are particularly effective.

The choice of surgical manipulations is quite wide, their use depends on the stage and type of tumor:

• Cryotherapy – removal of neoplasia using liquid nitrogen. An effective and safe method, used in the initial phases.
• Electroexcision - excision of a neoplasm with the help of an electroneedle.
• Laser destruction - removal of pathology using a special laser, without affecting the surrounding, intact tissues.
• Excision - a method in which a neoplasia is cut with a scalpel in the volume necessary for this case, possibly including healthy tissues, even subcutaneous tissue, as well as fascia with regional lymph nodes. A radical method can help with late stages of the disease.

The prognosis can be very diverse, it all depends on the type and stage of the disease. In the absence of metastases and adequate treatment, the chances of a favorable outcome reach 80-90%. The more widespread the cancer process, the lower the chances of a good result.

Prevention of skin cancer

In order to significantly reduce the probability of the occurrence of an oncological process in the tissues of the skin, it is necessary to observe some points. Important:

• Minimize the time spent in the open sun, especially during its peak.
• Protect your skin with clothing or by using special topical sunscreens.
• Periodically examine your own skin so as not to miss the appearance of a neoplasm.
• At the slightest suspicion, contact a dermatologist, who will tell you what further steps to take.
• Find out from the doctor what skin cancer looks like and what to do in case of detection.
• Will regularly undergo scheduled health checks.

Remember that it is important to be oncologically aware, because it will help to detect skin cancer early, the treatment of which in the initial stage is highly likely to prevent fatal consequences. Take care of your health.