Dermatology

Basal Cell Carcinomas (BCCs) show up most commonly as shiny pearly bumps on sun-exposed areas of the skin. They can also appear as non-healing red or pink spots that are flat or raised. They can bleed or cause irritation. Some basal cells can even have color or pigment in them appearing brown or dark like a melanoma. There are close to 1 million cases in the United States every year. The scalp, face, ears, and arms are the most frequent sites of involvement as the sun is thought to play an important role in causing these types of cancer. Thankfully, these usually stay localized in the area where they start but they can rarely spread to other areas of the body. I have personally seen a case of basal cell that involved the entire upper back of a person who let it go over 10 years without seeing their doctor. The most dangerous areas to get a basal cell are near the eyes, ears, or nose where there can be a lot of damage and disfigurement if not caught early. BCCs are more common in older patients but I have seen them in patients as young as ten years old (this is very rare). There is also a genetic syndrome known as basal cell nevus syndrome where patients can get over a hundred or more BCCs over their lifetime. If you have had a BCC, I recommend being checked every 6 months by your dermatologist. More information is available at the Skin Cancer Foundation – Basal Cell Carcinoma.

Squamous Cell Carcinomas (SCCs) usually occur as red crusty bumps on the skin, again most often on sun-exposed areas such as the scalp, face, ears, and arms. SCCs can also show up as non-healing red patches which are flat or raised. Some of these patches can even look like dermatitis, eczema, or psoriasis but the key is that they do not seem to go away or get better with treatment. SCCs are also more likely to occur in burns and scars. There are over 250,000 cases a year in the United States. Squamous cell carcinomas are more likely than basal cell carcinomas to metastasize or spread to other parts of the body. There are unfortunately about 2500 or so deaths each year in the US from SCCs. If you have had a SCC, I recommend being checked every 6 months by your dermatologist. More information is available at the Skin Cancer Foundation – Squamous Cell Carcinoma.

Melanoma is the most serious form of skin cancer. Melanoma is now expected to affect 1 in every 55 Americans in their lifetime, and it kills one American about every hour. It usually shows up as a dark spot but not always. I have personally treated melanomas that were pink or red in color and had no darkness at all to them. The ABCDs are important in melanoma detection and they stand for A (Asymmetry – one half of the mole looking different from the other half), B (Border – irregular or jagged), C (Color – uneven, different shades), and D (Diameter – more than 6 mm or the size of a pencil eraser). Recently, we have also noted that any changes in moles should be taken seriously. These may include changes in general appearance, elevation, itching, bleeding, irritation, or even a vague feeling to the mole that you cannot quite describe. Melanomas can occur as a completely new mole or occur within an old mole that has been there for years or even since birth. I cannot tell you how often patients have come in with moles that they think are changing which we have then removed and detected skin cancer. There are close to 60,000 new cases in the US every year, and unfortunately over 8,000 deaths. Melanoma is the most likely to spread to other areas of the body. It can grow in areas that have seen very little sun such as the feet and buttocks and even the eyes. It is also a cancer that can stay away for ten or more years, only to come back after seemingly being cured. Melanomas can be cut out with a simple procedure in the office with local numbing. More information is available at: National Cancer Institute – Melanoma National Cancer Institute – Melanoma Treatment