Basal Cell Carcinoma (BCC)

It is the most common cancer type. It occurs in parts of the body that are exposed more to the sun, such as the face (nose, forehead, hairline), neck, and back. Various factors are implicated in its occurrence, such as tanning techniques (solarium), contact with arsenic, open wounds that do not heal, chronic skin conditions (actinic keratosis, smooth lichen, lupus, and psoriasis), burn complications and scars, gene mutations, and the basal cell nevus, nevoid basal cell Ca and Gorlin syndromes.

Groups with a high risk to develop basal cell carcinoma are composed of individuals with immunodeficiency, and fair complexion, and individuals who are exposed to solar radiation for long periods at work, with personal and family history of skin malignancies. Although, it rarely gives metastases, it has a tendency to grow, and destroy the surrounding tissues. This fact, as well as its tendency to recur in the same or other areas, make its treatment necessary.

Treatment

Its surgical treatment consists of its complete removal, usually under local anesthesia at the doctor’s office.

Squamous Cell Carcinoma (SCC)

It is the second most prevalent skin tumor after Basal Cell Carcinoma, and the most aggressive tumor after Melanoma. It usually occurs in parts of the body that are exposed more to the sun, such as the face, hands, and feet, and more rarely in mucous such as the mouth, and genitals. The occurrence of SCC in an area of the body has been preceded by lesions, such as wrinkles, color change, and elasticity loss. The same, more or less, factors are implicated in its occurrence, as in BCC: chronic exposure to the sun, artificial tanning (solarium), skin injuries, chronic inflammations and ulcers, burns, and exposure of skin areas to radiation or chemicals, such as arsenic. A high SCC incidence is shown by groups of people with immunosuppression (chemotherapy, drugs to avoid rejection in organ transplantation), infection by the human immunodeficiency virus (HIV), and hereditary predisposition, who have precancerous lesions on their body, such as actinic hyperkeratosis, actinic cheilitis, leukoplakia, and Bowen’s disease.

Diagnosis is based on clinical examination by a Dermatologist, dermatoscopy, and biopsy, if the lesion is big.

Treatment

A surgical treatment consists of complete removal under local anesthesia in a septic operation room at the doctor’s office. Due to its tendency to expand to the surrounding tissues, its diagnosis and removal should be made as early as possible.

Melanoma

Melanoma is the most malignant skin cancer, and one of the most aggressive. It results from melanocytes in the basal layer (stratum basale) of the epidermis. It is found mostly on the skin, but it can also be noticed in mucous, such as the eye, meninges, and intestine. The main causes for the occurrence of melanoma are the exposure to ultraviolet radiation, phenotypic characteristics, i.e. Fitzpatrick phototypes I and II, high number of melanocytic or presence of dysplastic nevi, large-sized congenital nevi, personal or family history of melanoma, hereditary mutation in the CDK4 and CDKN2A genes, transformation of lentigo maligna, congenital nevi, and melanocytic nevi, chronic nevi irritation, and immunosuppression, while female hormonal changes during pregnancy or taking contraceptives are also implicated.

Melanoma is characterized by a series of clinical characteristics that are known as the ABCDE rule. This is very important for an early diagnosis that will also largely determine disease prognosis.

–Asymmetry

–Border: irregular border

–Colour: recent color change or various colors

–Diameter: > 6 mm

–Elevation: elevation or palpable nodule

Melanoma can give metastases to lymph nodes, as well as through blood-borne transmission to remote organs. Therefore, it is very important to have an early diagnosis by a dermatologist through clinical examination, dermatoscopy, and finally, biopsy. The next step after diagnosis is melanoma staging. This is determined by measuring its thickness, and depth that it has reached, and whether there are any metastases in the adjacent lymph nodes or other body organs.

Treatment

Depending on the stage, the treatment type will also be determined. Surgical operation is the main treatment method for melanoma. Complete resection of the primary tumor is performed, and depending on the stage and sentinel lymph node, the patient undergoes lymph node cleaning in the suffering area. In advanced melanoma forms, chemotherapy, immunotherapy (interferon, ipilimumab), and radiation therapy, to a lesser extent, are applied.