All you need to know about skin cancer

Written by: Dr. Xavier Bordas Orpinell
Published: | Updated: 13/11/2018
Edited by: Noelia Pino García

Skin cancer is uncontrolled proliferation of malignant cells by their ability to infiltrate surrounding tissues or metastasize distance. There are different types of skin tumors and biological behavior of each of them is extremely variable. The prognosis, therapeutic approach and, ultimately, the importance of a tumor of the skin depends, among other things, the type of skin cancer in each case.

Skin cancer types

Types of skin cancer

There are numerous types of skin cancer cell line according involved: Merkel cell tumor, protuberant Dermatofibrosarcoma, various types of cutaneous lymphoma, etc.

However, the two most common are: malignant melanoma and carcinomas, which in turn are divided into basal cell carcinoma and squamous cell carcinoma.

Malignant melanoma is one of the tumors of the body with the greatest potential to put a patient's life at risk, as it may determine metastasis even when its size is relatively small. However, its location on the skin, naked in the eyes, gives the opportunity to detect early and remove it before its expansion to other territories.

Basal cell carcinoma is usually an injury without the ability to metastasize (described only in exceptional cases) so its malignancy is often merely local. In many cases not only it is clearly invasive lesions so its surgical removal or destruction with other methods like electrofulguration and curettage, cryotherapy intense, radiation, laser and certain topical products, often leads to definitive cure. Only in certain cases, particularly in relation to certain anatomical locations can be locally invasive and require drastic and occasionally mutilating surgical procedures.

Squamous cell carcinoma usually appears on chronically damaged by the sun areas, often developed on precursor lesions called actinic keratoses. In these cases, their ability to metastasize and compromise the patient's life is highly unlikely given that over an extended period of time there is an opportunity to eradicate with different therapeutic options, especially surgically. However, squamous carcinoma of mucous membranes (lips, tongue, oral and genital mucosa in general) involves greater risk and is not uncommon expansion to regional lymph nodes and, occasionally, to distant organs


Warning Signs Skin Cancer

It is very important to check for any skin lesion emerging that persists beyond a few weeks. Both malignant melanoma as the two types of carcinoma are more common in people with fair skin that has been damaged by sun exposure.

Regarding malignant melanoma patients should consult your dermatologist before any of the following circumstances:

  • Appearance of a new mole in adulthood. In children it is normal for new moles are appearing.
  • Any change in an existing mole: color change, enlargement, bleeding or crusting on the surface.
  • Moles with irregular borders, more than 6 mm, heterogeneous color.

As for the infiltrative basal cell carcinoma it should be noted that may initially appear as an injury of innocent appearance; for example, a small scab that is clear and renewed without ever heal. Any injury of this nature in the face that persists beyond three or four weeks should be explored by the dermatologist.

Squamous cell carcinoma may appear on a skin or mucosa apparently healthy but often develops as the final stage of precancerous lesions damaged by chronic sun exposure areas. Within precursor lesions of this type of cancer, the most common are called actinic keratoses. It is shaped formations very adherent yellowish-white, flake and rough touch. They often present as multiple lesions in areas exposed to the sun for light-skinned people. The treatment of these injuries will prevent its eventual passage squamous carcinoma.

In the case of squamous cell carcinoma of mucous membranes, poor prognosis, they may also be emerging or precursor lesions that offer the possibility of early treatment. Above all you should consult a specialist before the appearance of whitish lesions of the oral mucosa known as leukoplakia.


Skin Cancer Treatment

Surgery is the treatment of choice in most cases of skin cancer.

  • In the case of malignant melanoma, the surgical approach may range from a simple removal to disposal with wide safety margins and eventually removal of the corresponding regional lymph. All this depends on the degree of skin depth has been seen on biopsy.
  • As for metastatic melanoma obviously it darkens the prognosis, but new drugs that might even end up controlling these very advanced cases are appearing.
  • Mucosal squamous cell carcinoma surgery also requires safety margins and occasionally radiotherapy.
  • The superficial basal cell carcinoma can be treated with very conservative measures (even with local application of creams that have the power to destroy selectively malignant cells).
  • In the infiltrative basal cell carcinoma, the treatment is surgery again with large safety margins. Sometimes has to resort to the so-called Mohs surgery is to remove the tumor tissue with intra-operative biopsies indicate to the surgeon whether to further expand the area.


Skin cancer prognosis

The prognosis of skin cancer depends heavily on the degree of delay in diagnosis and treatment.

Undoubtedly, malignant melanoma is cutaneous tumor with the worst prognosis when not treated on time, as may be extended remotely (metastasis) even for relatively small size lesions. Squamous cell carcinoma of mucous follow in order of "malignancy". Cutaneous squamous cell carcinoma provides a "window of opportunity" too big for its healing. Precancerous lesions, actinic keratosis type, can be resolved with simple measures such as cryotherapy or application of topical products. Even when cutaneous squamous carcinoma has already developed often it can be cured with a simple surgical removal.

The infiltrative basal cell carcinoma has a poor prognosis only when it has invaded regions that require mutilating surgery (periorbital areas, invasion of nasal cartilage or headphones).

The infiltrative basal cell carcinoma is not very good prognosis, to the extent that sometimes can be treated without surgery.

*Translated with Google translator. We apologize for any imperfection

By Dr. Xavier Bordas Orpinell

Reference in Dermatology, Dr. Bordas Orpinell specializes in psoriasis, having participated as principal investigator in numerous clinical trials with new molecules psoriasis. He is also Head of the Dermatology Service of the University Hospital of Bellvitge. He has attended more than 150 national and international conferences and training courses, while, on the other hand, presented to 140 communications, papers in scientific conferences and meetings. He has published over 75 scientific articles in national and international medical journals. He is a member of various medical societies.

*Translated with Google translator. We apologize for any imperfection

View Profile

Overall assessment of their patients