Skin cancer is the uncontrolled growth of abnormal skin cells. It occurs when unrepaired DNA damage to skin cells (most often caused by ultraviolet radiation from sunshine or tanning beds) triggers mutations (genetic defects) that lead the skin cells to multiply rapidly and form malignant tumors. Cancerous tumors may spread, invading and damaging nearby tissue. In some cases, skin cancers can spread to vital organs, becoming deadly.
Skin cancer is the most common form of cancer in the United States. More than 3.5 million skin cancers in over two million people are diagnosed annually. Each year there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon. One in five Americans will develop skin cancer in the course of a lifetime. Nearly 800,000 Americans are living with a history of melanoma and 13 million are living with a history of nonmelanoma skin cancer, typically diagnosed as basal cell carcinoma or squamous cell carcinoma.
it is estimated that up to 58 million people will develop actinic keratoses (AK). Actinic keratosis can be the first step leading to squamous cell carcinoma and is therefore known as a “pre-cancer.” Although the vast majority of actinic keratoses remain benign, some studies report that up to 10 percent may advance to squamous cell carcinoma. This percentage does not sound very large, but it has a large impact. When it comes to squamous cell carcinomas, 40-60 percent begin as untreated actinic keratoses and may advance to invade the surrounding tissues. About 2 to 10 percent of these squamous cell carcinomas spread to the internal organs and are life-threatening.
Squamous Cell Carcinoma
Squamous cell carcinoma (SCC) is an uncontrolled growth of abnormal cells arising in the squamous cells, which compose most of the skin’s upper layers (the epidermis). SCCs often look like scaly red patches, open sores, or warts; which they may crust or bleed. Squamous Cell Carcinoma is mainly caused by cumulative UV exposure over the course of a lifetime.
Basal Cell Carcinoma
Basal Cell Carcinoma (BCCs) are abnormal, uncontrolled growths or lesions that arise in the skin’s basal cells, which line the deepest layer of the epidermis (the outermost layer of the skin). BCCs often look like open sores, red patches, pink growths, shiny bumps, or scars. They usually are caused by a combination of cumulative UV exposure. Basal cell carcinoma can be highly disfiguring if allowed to grow, but almost never spreads (metastasize) beyond the original tumor site. Only in exceedingly rare cases can BCC spread to other parts of the body and become life-threatening.
Incidence of melanoma s approximately 68,130 new cases in United States There are around 8700 deaths in United States each year. Atypical moles or nevi may form into melanoma from genetic causes, ultraviolet radiation, the HPV virus, ionizing radiation, heat, trauma and chemical agents, such as: industrial oils, coal, petroleum, dyes, solvents, arsenic and pesticides. The ABCDEs of abnormal moles or nevi include: asymmetry, boarder irregularity, change in color, diameter, and evolving / growing lesions. Suspicious nevi with any of these characteristics should be evaluated by a primary care provider.
At UNPC Family Health Clinic we perform thorough skin assessments and annual skin examinations. Our Surgical Perioperative Nurse Practitioner, Jessica M. White will excise and biopsy abnormal moles or suspicious nevi in the office. Based on evaluation, exam, and biopsy reports the treatment may include cryotherapy, applied topical cream, immune response modifier medication, or photodynamic light therapies. Basel cell carcinoma and squamous cell carcinoma may require referral to a general surgery for more extensive removal and in advanced cases radiation.
Psoriasis is a chronic common skin disorder typically characterized by erythematous papules and plaques with a silver scale. It occurs in 1-3% of world population. In United States, psoriasis affects 2.5% Caucasians & 1.3% African Americans. Onset can occur at any age but peaks at 20s and 50s. Psoriasis has a genetic predisposition and siblings and offspring are at increased risk.
Psoriasis is an inflammatory skin disorder with reactive abnormal epidermal differentiation and hyperproliferation. This skin disease is thought to be immune based from dysfunction of regulatory T-cells. Exacerbating Factors of the disorder include local factors such as all types of trauma including physical, electrical, chemical, surgical, infective and inflammatory types of injury. Systemic exacerbating factors may occur from infection, HIV, drugs, emotional, smoking, alcohol misuse, and endocrinological factors. The koebner phenomenon is from lesions developing at skin sites of trauma
Mild disease may be treated with topical medications such as steroids, vitamin D analogs, and immunomodulators. Phototherapy such as Ultraviolet B (UVB) or Psoralen Plus Ultraviolet A (PUVA) phototherapy may be indicated in more moderate disease. Oral retinoids or systemic immunosuppressive medications may be appropriate for more advanced severity illness.
Eczema is a general term for any type of dermatitis or “itchy rash”. The word “eczema” is derived from a Greek word meaning “to boil over”. Symptoms include red, inflamed, itchy patches that occur during flareups of the disease. All types of eczemas can cause itching, redness, swelling, dry skin and some may blister, weep or peel There are several types of eczema:
- atopic dermatitis (AD)
- allergic contact dermatitis
- irritant contact dermatitis
- dyshidrotic eczema
- nummular (discoid) eczema
Additional testing may be completed to determine the cause or type of eczema that a person is exhibiting symptoms of. Treatment includes avoiding triggers, topical corticosteroids, immunomodulator creams, emollients, UV light therapy, and advanced cases benefit from immunosuppressive agents.