The skin has many very important functions in the human body. It covers the entire body and has a surface area of approximately 2m2. Unfortunately, both the external factors to which it is exposed every day and various diseases can contribute to the development of skin changes. Some of them accompany us from birth. Skin cancer is still a huge challenge for many doctors. Most often, the patient is referred to a dermatologist at the initial diagnostic stage, only to find out that surgical and oncological help is required. What do we know about skin cancer?
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Skin tumours
Skincancers can develop on any part of our body. In most cases, they develop from atypical skin lesions that have been present on our body for many years. Importantly, they can occupy hairy parts of the body such as the head or armpit. They develop in most cases in "latency" over many years. It is a multi-stage process and, importantly, the patient does not experience any symptoms. The lesion on the skin in its early stages does not resemble a tumour at all. There is also no certainty that every atypical skin lesion will develop into a neoplasm 100% of the time. This is because there are cases in which it disappears spontaneously. Some tumour processes are activated by various external factors, such as sunlight or UV radiation, or internal factors (co-morbidities and the use of certain drugs).
As soon as you notice any worrying change on your skin, such as an enlarged, scaly, painful or bleeding lesion, you should immediately contact a dermatologist. If in doubt, you will be referred to a surgical oncologist. A wider clinical diagnosis will allow us to determine the nature of the lesion.
The most common skin lesions
The most common skin lesions that may lead to cancer or are cancerous are:
Basalcell carcinoma (carcinoma basocellulare, basalioma), which is the most common skin neoplasm with about 75% of all cases. It infiltrates tissues, very rarely metastasises and its growth is localised. Unfortunately, at a very advanced stage, it destroys and damages not only the skin, but also the subcutaneous tissue and deeply situated tissues (bones, tendons). Prompt diagnosis of cancer gives a chance of a 100% cure. Observations by doctors show that this cancer most often occurs in areas exposed to UV radiation. This cancer usually takes the form of hard, shiny, small nodules. Over time, ulceration appears at their edges. Their colour resembles ivory. The most commonly affected areas are the décolletage, shoulders, neck, eyelids and facial skin. At present, there are approximately 13 clinical and pathological forms of basal cell carcinoma.
Solar keratosis, is characteristic not only of older people, but also of those who are exposed to the sun. The problem appears in most cases after several years and manifests itself not only in flaky skin, but also in excessive dryness. In addition, the skin becomes less elastic and discolouration occurs. The lesions usually affect the skin on the temples, ears, auricles, forearms and lower legs. The keratosis foci adhere very tightly to the skin, and their rupture leads to the appearance of a bleeding wound. Treatment should always be preceded by a histopathological examination. If the tumour is not cancerous, liquid nitrogen freezing or photodynamic therapy is used. In many cases, surgical removal of the lesion is necessary.
Squamous cell carcinoma (squamous cell carcinoma, carcinoma spinocellulare), which originates from the keratinising cells of the epidermis. It is most commonly located on the head, but is also found on the neck, trunk or genitals. The tumour is characterised by rapid and rapid growth and the ability to metastasise. It is papillary, scaly, keratinised and very often covered with a scab. In its advanced stage, it is accompanied by pruritus, bleeding, swelling and infiltration of adjacent tissues. Squamous cell carcinoma is the most common tumour on the borderline between mucous membranes and skin. It is most common in the elderly, those treated with immunosuppressants or those exposed to UV radiation.
Melanoma malignoma is a particularly malignant tumour. It arises from melanocytes. The key point is that melanoma can arise from a pigmented nevus but also from unchanged skin. In most cases, it is located on the skin of the legs in the case of women and the back (men). Unfortunately, it can also develop in the retina, under the fingernails, soles of the hands and feet, in the mouth or rectum. Melanoma is characterised by its particular malignancy, ability to metastasise distantly (to the lungs, bones, muscles, blood, lymph) and poor response to treatment.
Suspected cancer, photo: shutterstock
The following types of melanoma can be distinguished:
- originating from a lentiginous spot,
- nodular,
- originating from lentigines located on the extremities,
- spreading superficially.
The prognosis of this type of tumour largely depends on its clinical variation but also on the depth of skin infiltration.
Bowen's disease, has been recognised as a pre-invasive form of squamous cell carcinoma. Patients' skin shows strongly demarcated, red and flat-lying lesions. They occur most commonly on the skin of the extremities and trunk. Factors contributing to the development of Bowen's disease include chronic skin diseases, toxins, skin damage, sun radiation and viral infections.
Sarcomas are tumours of soft tissues, but can also occur on the skin. The causes of their formation are not fully understood, but exposure to genetic factors and exposure to ionising radiation have an impact. It very often leads to metastases to the lungs, among other places. In most cases, they are located on the thighs, upper limbs and buttocks. The symptoms of sarcomas very often appear late and depend on the location of the lesion. Treatment involves surgical removal of the lesion. Sometimes it becomes necessary to remove muscles, vessels and nerves.
If you notice any disturbing lesion on your skin, which starts to hurt, bleed or enlarge very quickly, for example, you should visit a dermatologist as soon as possible. In most cases, a histopathological examination is performed and oncological or surgical intervention is necessary.
