Skin cancer can occur in many forms. There are over 1 million cases of skin cancer that occur every year in the United States alone. Also, patients with a history of sunburns, tanning, lots of moles, and a family history of skin cancer are at higher risk of developing such spots. The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma. The most important thing about skin cancers is early detection and treatment so that we can achieve the highest rates of cure. Melanoma is the most serious form of skin cancer and regular skin exams at home and annual exams with your dermatologist can help with early detection.
More information is available at the National Cancer Institute – Skin Cancer website.
Pre-cancers, otherwise known as actinic keratoses, are the rough scaly spots that are usually seen on sun-damaged parts of the skin. Many people do not realize that these spots, even though very common, can also be dangerous and a sign of an increased risk of skin cancer. They occur most commonly on the scalp, face, ears, lips, and arms. Women often also get these on the lower legs. It is important to diagnose and treat pre-cancers because if left alone, they can turn into a form of skin cancer known as squamous cell carcinoma. There are many forms of treatment for pre-cancers including freezing as well as different types of creams.
More information is available at American Academy of Dermatology – Actinic Keratoses Net
Rashes can occur in many varieties. The most common rashes dermatologists see are atopic dermatitis or eczema and poison ivy or oak. Eczema can occur in children and in some cases get better as they grow older. In adults, this can show up as hand or foot rashes that easily flare up. There are a lot of new treatments available now for these conditions, including foams and sprays that are much more easily spread on the skin than the older greasy ointments and creams. Also, non-steroid treatments are available within the last few years that can help us avoid some of the side effects of steroid creams. Poison ivy or oak, if properly diagnosed and treated, does not have to be the severely itchy blistery widespread rash if often becomes without early therapy.
More information is available at:
American Academy of Dermatology – Eczema Net
Acne is one of the most common conditions any dermatologist sees day to day. But acne is a very serious condition that can be treated with many different forms of medications to achieve good control. Unfortunately, in too many cases, acne can have a physical and psychological impact on many teenagers and adults because of the pigment changes and scars it often leaves behind. One of our most important goals is to get the acne under control before irreversible scarring has occurred. Treatment can include creams or oral medications. There are new low dose forms of oral antibiotics available to decrease the side effects from some of the higher doses of these medications. Also, for the most serious cases, Accutane is available.
More information is available at:
American Academy of Dermatology – Acne Net
Moles are flat or raised spots that can occur almost anywhere on the skin. You can be born with moles or can develop them as a teenager or even as an adult. Moles can sometimes turn into skin cancer and therefore should be watched closely. Awareness of one’s own moles is the key to prevention. Any mole that is changing, growing, itching, bleeding, or feeling strange in any way should be immediately checked by your dermatologist. Moles do not have to be new in order to be changing. If your dermatologist feels that the mole is suspicious, a simple biopsy can be done in the office with a small amount of local numbing medicine.
Warts are seen mostly in children. They are caused by a virus and easily spread from one person to another by contact. Often, warts will spread – starting as one or two spots and then moving to new areas from there. Many treatments from liquid nitrogen to creams and even oral medications can be used for warts. Genital warts can be serious not only because of their appearance, but because the virus can be associated with increased risk of cervical cancer in some women.
Up to 7.5 million Americans have psoriasis. Psoriasis has been a physically and psychologically devastating disease for many patients. However, we have made great strides now with a lot of treatment options which we never had before. These include biologic medications such as Enbrel (etanercept), Humira (adalimubab), Amevive (alefacept), and Raptiva (efalizumab). New topical medications are available in foam and spray forms which are more easily applied on the skin. Oral medications such as methotrexate and Soriatane are available for the right patient. Finally, a lot of patients even with mild skin psoriasis may be suffering from psoriatic arthritis, which also responds to a great many of the treatments mentioned above.
More information is available at the National Psoriasis Foundation.
Over 14 million Americans have rosacea. There are three types of rosacea dermatologists usually see – vascular (erythematotelangiectatic), papulopustular, and a combination. Ocular rosacea involves discomfort or grittiness in the eyes that can be treated. Rare types that are more serious are the phymatous type (with an enlarging bulb-like nose) or the granulomatous type that can leave more scarring. Most people do not realize that rosacea is a treatable condition. They often suffer embarrassment and redness on the face when dermatologists have many different treatments available.
There is also a lot of great information available at the National Rosacea Society.
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
Sometimes, all of us have spots or moles that are in locations that are cosmetically bothersome. These can easily be removed with a short outpatient procedure in the office. Although moles that are not changing or causing irritation are not covered by insurance, we can still remove them for cosmetic purposes.