Skin Cancer Lesions
Skin Cancer Lesions
Frank Scaccia MD FACS an Award Winning Dual Board Certified Facial Plastic Surgeon and Otolaryngologist ENT Ear Nose and Throat specialist performs Mole and Skin Cancer procedures in his own private OR Surgical Suite within his Ambulatory Surgical Center. The Center is one of just a few in New Jersey (be sure and see the Virtual Tour link to the left)
Covered by many insurance companies.
Forms of Skin Cancers
Consistently the most frequently occurring is Basal Cell Carcinoma (BCC)
The Second most common form of skin Cancer is Squamous Cell Carcinoma (SCCs)
BCC and SCC are the two most common forms of Skin Cancers.
Dr Frank Scaccia and his Riverside Plastic Surgery and Sinus Center has all the information you will ever need about the prevention, detection, and treatment of basal cell carcinoma. The Primary Procedure for BCC and SCC is Excision with Frozen Section Control – Pathology performed only by Board Certified Pathologists
Basal Cell Carcinoma (BCC)
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.
Usually caused by a combination of cumulative UV exposure and intense, occasional UV exposure, BCC can be highly disfiguring if allowed to grow, but almost never spreads (metastastasizes) beyond the original tumor site. Only in exceedingly rare cases can BCC spread to other parts of the body and become life-threatening.
Basal cell carcinoma affects up to two million Americans each year. In fact, it is the most frequently occurring form of all cancers. More than one out of every three new cancers are skin cancers, and the vast majority are BCCs.
It shouldn’t be taken lightly: this skin cancer can be disfiguring if not treated promptly. Are you at risk?
The Second Most Common Form of Skin Cancer – Squamous Cell Carcinoma SCC
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; they may crust or bleed. SCC is mainly caused by cumulative UV exposure over the course of a lifetime. It can become disfiguring and sometimes deadly if allowed to grow. An estimated 700,000 cases of SCC are diagnosed each year in the US, resulting in approximately 2,500 deaths.
SCCs may occur on all areas of the body including the mucous membranes and genitals, but are most common in areas frequently exposed to the sun, such as the rim of the ear, lower lip, face, bald scalp, neck, hands, arms and legs. Often the skin in these areas reveals telltale signs of sun damage, such as wrinkling, changes in pigmentation, and loss of elasticity. Melanoma Introduction
Melanoma is a cancer that develops in melanocytes, the pigment cells present in the skin. It can be more serious than the other forms of skin cancer because it may spread to other parts of the body (metastasize) and cause serious illness and death. About 50,000 new cases of melanoma are diagnosed in the United States every year.
Because most melanomas occur on the skin where they can be seen, patients themselves are often the first to detect many melanomas. Early detection and diagnosis are crucial. Caught early, most melanomas can be cured with relatively minor surgery.
Individual sunburns do raise your risk of melanoma . However, slow daily sun exposure, even without burning, may also substantially raise your risk of skin cancer.
Factors that can raise the risk of Skin Cancer:
Caucasian (white) ancestry
Fair skin, light hair, and light-colored eyes
A history of intense, intermittent sun exposure, especially in childhood
• Many (more than 100) moles
• Large, irregular, or “funny looking” moles
• Close blood relatives — parents, siblings, and children — with melanoma
The presence of close (first-degree) family with melanoma is a high risk factor, although looking at all of melanoma, only 10% of cases run in families.
How do you estimate the level of risk for melanoma?
The best way to know your risk level is to have Dr Frank Scaccia perform a full body examination. That way you will find out whether the spots you have are moles and, if so, whether they are “funny looking” in the medical sense.
The medical term for such moles is “atypical.” This is a somewhat confusing term, because among other things the criteria for defining it are not clear, and it’s not certain that an atypical mole is necessarily precancerous. If you have such moles, Doctor Scaccia may do a biopsy in order to counsel you about the need for surveillance or further testing.
Sometimes, you may learn at a routine skin evaluations and possibly in our Medi Spa that you do not necessarily need annual routine checkups. In other situations, Doctor Scaccia may recommend regular checks at six-month or yearly intervals.
What are the types of melanoma?
Anyone with a family history of melanoma they should make an appoint and visit Dr Frank Scaccia for an annual skin examination.
Plus Everyone should know the ABCDEs of Melanoma:
A: Asymmetry, which occurs when the two halves of the mole are not identical
B: Borders that are irregular or indistinct
C: Color that varies in a single mole
D: Diameter, which should be no larger than a pencil eraser (about 6 mm)
E: Elevated above the surrounding tissue.
The main types of Melanoa are:
1. Superficial spreading melanoma: This type accounts for about 70% of all cases of melanoma. The most common locations are the legs of women and the backs of men, and they occur most commonly between the ages of 30 and 50. (Note: Melanomas can occur in other locations and at other ages as well.) These melanomas are often barely raised and have a variety of colors. Such melanomas evolve over one to five years and can be readily caught at an early stage if they are detected and removed.
2. Nodular melanoma: About 20% of melanomas begin as deeper, blue-black to purplish lumps. They may evolve faster and may also be more likely to spread.
3. Lentigo maligna: Unlike other forms of melanoma, Lentigo maligna (melanotic freckle of Hutchinson) tends to occur on places like the face, which are exposed to the sun constantly rather than intermittently.
4. Lentigo maligna looks like a large, irregularly shaped or colored freckle and develops slowly. It may take many years to evolve into a more dangerous melanoma.
There are also other rarer forms of melanoma that may occur, for example, under the nails, on the palms and soles, in the eye, or sometimes even inside the body. Treatment of Melanoma by stage
The type of treatment(s) Doctor Scaccia recommends will depend on the stage and location of the melanoma and on your overall health. Melanoma recurrence after excision. Is a wide margin justified?
Research study through retrospective analysis of patient records for 187 patients with melanoma the aim of this study was to determine whether outcome varied according to degrees of surgical intervention in the primary treatment of stage I disease for thin, intermediate, and thick lesions. There were no significant differences in recurrence rate associated with an excision margin of 15 mm or less compared with wider excision margins; with initial excision compared with wider re-excision after excision biopsy; or for primary closure as compared with closure with a graft. There was, however, a significant difference in wound complication rate between wounds closed primarily (6%) and those closed by grafting (31%) (p < 0.01). The researchers advocate the more conservative excision margin of 1.00 cm to 1.50 cm in the treatment of stage I melanoma with primary closure of the wound where possible.
Pre invasive skin lesions – Pre-Melanoa
These lesions are difficult to diagnose and the patient may only have noticed a minimal change in a long standing mole such as in size, shape or color.
A pre invasive melanoma is almost always cured by complete local excision.
The terms dysplastic naevus and melanoma – in – situ may be used.
If you are worried about a skin lesion, the best way to be sure is to have a trained health professional such as Dr Frank Scaccia check it for you. Look at lesions just like those on this site pick up the ones which require the attention of Dr Scaccia. (Photos to come)
A good way of remembering the tell tale signs of melanoma is the ABCDE system
A: Asymmetry: one half of a mole or birthmark does not match the other half.
B: orders: irregular, ragged edges of a mole.
C: Color: irregular color, ranging from shades of black, brown, or tan (sometimes pink, white, red, or blue) within one sore. A normal mole tends to have an unvarying brown color.
D: Diameter: the spot is typically (not always) larger than 6 millimeters in diameter—the size of a pencil eraser.
E: Evolving: this is a new addition to the former ABCD list; it acknowledges that if a mole changes—in any way—this is good cause to see Doctor Frank Scaccia