Skin cancer is the most common type of cancer with over 1 million new cases being diagnosed each year alone in the United States. The physicians at Arkansas Dermatology Skin Cancer Center treat many types of precancerous and cancerous skin conditions on a daily basis. When it comes to skin cancer, we have the experience you expect and the training you trust.
Actinic Keratosis | Basal Cell Carcinoma | Squamous Cell Carcinoma | Malignant Melanoma | Dermatofibrosarcoma Protuberans | Atypical Fibroxanthoma
What is Actinic Keratosis?
An actinic keratosis, also known as a solar keratosis, is a scaly or crusty growth (lesion). It most often appears on the bald scalp, face, ears, lips, backs of the hands and forearms, shoulders, neck or any other areas of the body frequently exposed to the sun. You’ll most often see the plural, “keratoses,” because there is seldom just one. Actinic keratosis is also known as a “pre-cancer.”
What do Actinic Keratoses look like?
In the beginning, actinic keratoses are frequently so small that they are recognized by touch rather than sight. It feels as if you were running a finger over sandpaper. Often times, actinic keratoses develop slowly and reach a size from an eighth to a quarter of an inch. They may disappear only to reappear later. Most become red, but some will be light or dark tan, pink, a combination of these, or the same color as your skin. Occasionally they itch or produce a pricking or tender sensation. They can also become inflamed and surrounded by redness. In rare instances, actinic keratoses can even bleed.
What does it mean if I have Actinic Keratoses?
Actinic keratoses indicate that you have sustained sun damage and could develop skin cancer. These lesions are usually easily treatable.
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Basal Cell Carcinoma
Basal cell carcinoma is the most common form of skin cancer, affecting over 1 million Americans each year. More than one out of every three new cancers are skin cancers, and the vast majority of these are basal cell carcinoma.
Where do Basal Cell Carcinomas Appear?
Almost all basal cell carcinomas occur on parts of the body excessively exposed to the sun – especially the face, ears, neck, scalp, shoulders and back. On rare occasions, however, tumors develop on unexposed areas. In a few cases contact with arsenic, exposure to radiation, open sores that resist healing, chronic inflammatory skin conditions, and complications of burns, scars, infections, vaccinations or even tattoos are contributing factors.
Who gets it?
Anyone with a history of sun exposure can develop basal cell carcinoma. People who are at highest risk have fair skin, blond or red hair, and blue, green or grey eyes. Those most often affected are older people, but as the number of new cases has increased sharply each year over the last few decades, the average age of patients at onset has steadily decreased. The disease is rarely seen in children, but occasionally a teenager is affected. Dermatologists report that more and more people in their twenties and thirties are being treated for this skin cancer. Workers in occupations that require long hours outdoors and people who spend their leisure time in the sun are particularly susceptible.
How is Basal Cell Carcinoma treated?
Basal cell carcinomas are usually easily treated in their early stages. The larger the tumor has grown, however, the more extensive the treatment needed. Although this skin cancer seldom spreads, or metastasizes, to vital organs, it can damage surrounding tissue, sometimes causing considerable destruction and disfigurement – and some basal cell carcinomas are more aggressive than others. When small skin cancers are removed, the scars are usually cosmetically acceptable. If the tumors are very large, a skin graft or flap may be used to repair the wound in order to achieve the best cosmetic result and facilitate healing.
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Squamous Cell Carcinoma
More than 250,000 new cases of squamous cell carcinoma are diagnosed every year making this the second most common skin cancer. This form of skin cancer arises in the squamous cells that make up most of the skin’s upper layers (epidermis). Squamous cell carcinomas 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.
Who gets Squamous Cell Carcinoma?
People who have fair skin, light hair, and blue, green or gray eyes are at highest risk of developing the disease. But anyone with a history of substantial sun exposure is at increased risk. Those whose occupations require long hours outdoors or who spend extensive leisure time in the sun are in particular jeopardy. The majority of skin cancers in African Americans are squamous cell carcinomas, usually arising on the sites of preexisting inflammatory skin conditions or burn injuries. Though naturally dark-skinned people are less likely than fair-skinned people to get skin cancer, it is still essential for them to practice sun protection.
What causes it?
Chronic exposure to sunlight causes most cases of squamous cell carcinoma. Frequent use of tanning beds also multiplies the risk of squamous cell carcinoma; people who use tanning beds are 2.5 times more likely to develop squamous cell carcinoma than those who don’t. But skin injuries are another important source. The cancer can arise in burns, scars, ulcers, long-standing sores and sites previously exposed to X-rays or certain chemicals. Chronic infections and skin inflammation can also give rise to squamous cell carcinoma. Furthermore, HIV and other immune deficiency diseases, chemotherapy, anti-rejection drugs used in organ transplantation, and even excessive sun exposure itself all weaken the immune system, making it harder to fight off disease and thus increasing the risk of squamous cell carcinoma and other skin cancers.
How is Squamous Cell Carcinoma treated?
It is very important to have squamous cell carcinomas treated in a timely manner. The larger the tumor has grown, the more extensive the treatment needed. When small skin cancers are removed, the scars are usually cosmetically acceptable. If the tumors are very large, a skin graft or flap may be used to repair the wound in order to achieve the best cosmetic result and facilitate healing.
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Melanoma is a type of skin cancer. It comes from the cells in the skin that produce pigment called melanocytes. Melanoma is potentially a deadly skin cancer. Fortunately, it can be usually treated effectively if it is identified and treated in its early stages.
What is the prognosis for Melanoma?
The prognosis (or how well you will do) for melanoma depends on the stage of the cancer at the time of diagnosis. The stage of cancer is based on features of the melanoma, such as its thickness and whether or not there is any evidence of melanoma elsewhere in the body.
The most important factor associated with survival in patients with melanoma is the thickness of the melanoma. Thickness is most commonly reported as a measurement of depth given in millimeters (mm). This measurement of thickness is called the Breslow's depth. Sometimes the thickness is reported in a different way called the Clark's level. Clark's levels are designated with the roman numerals I through V, with I being the thinnest and V being the thickest.
In general, the thicker the melanoma is the worse the prognosis. Some melanomas are designated as melanoma in situ. In situ means that the melanoma is limited to the uppermost portion of the skin called the epidermis. Melanoma in situ has a Breslow's depth of zero and a Clark's level of I. These melanomas have a long term survival rate of nearly 100 percent with appropriate surgery. Melanomas with a Breslow's depth of less than 1mm are considered thin melanomas and have a favorable long term prognosis. The long term survival rate is about 90 to 95 percent with appropriate surgical treatment. For melanomas with a Breslow's depth greater than 1 mm, the long term survival rate gradually decreases with increasing depth of melanoma.
What treatments are available for Melanoma?
While surgery is the main treatment for melanoma and the treatment with the greatest chance of a cure, some patients with melanoma have chemotherapy in addition to surgery. Chemotherapy is usually reserved for patients whose melanoma has already spread to other parts of the body at the time of surgery. Several different chemotherapy regimens are available. No single regimen has been shown to dramatically prolong survival, but clinical trials are underway to discover better medical treatments for melanoma.
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Dermatofibrosarcoma protuberans (DFSP) is a relatively uncommon skin cancer. Although it is rare for this cancer to spread throughout the body via the bloodstream, the tumor can be locally aggressive with a high recurrence rate.
Who gets it?
Dermatofibrosarcoma protuberans has been reported in persons of all races, and no racial predilection seems to exist in previous reports. However, a more recent study conducted found the incidence among African Americans was almost double the incidence among American whites. Several studies of DFSP reveal an almost equal sexual distribution or a slight male predominance. Dermatofibrosarcoma protuberans usually occurs in adults aged 20-50 years. Rarely, DFSP has been reported in newborns and elderly individuals. Sunlight is not thought to play a role in developing DFSP.
What causes DFSP?
Currently, the cause of dermatofibrosarcoma protuberans is unknown. Laboratory studies have shown that chromosomal aberrations may be contributing causes of DFSP; however, no evidence of hereditary or familial predisposition exists. In 10-20% of patients with this tumor, trauma at the site seems to be incriminated. Surgical and old burn scars and sites of vaccinations have all been reported as sites of DFSP.
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Atypical fibroxanthoma (AFX) is a tumor that occurs primarily in older individuals after the skin of the head and neck has been damaged significantly by sun exposure and/or therapeutic radiation. Clinically, lesions usually are suggestive of malignancy because they arise rapidly (over just a few weeks or months) in skin in which other skin cancers have been found and treated.
What Causes AFX?
Sun exposure and/or therapeutic radiation that have caused significant skin damage are associated with the development of AFX. The most effective treatment for the removal of an AFX is Mohs Micrographic surgery.
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