Skin Cancer




Skin cancer is the most common type of cancer in the U.S.  3 million cases of skin cancer are diagnosed annually in the U.S.  1 in 5 Americans will be diagnosed with skin cancer over there lifetime.  Melanoma is the fastest growing preventable cancer in the U.S.

Types of Skin Cancer:

1. non-Melanoma, of which there are 2 kinds

  • Basal Cell Cancer (BCC ) and Squamous Cell Cancer (SCC)
  • BCC
    • 3 kinds: superfical, nodular, morpheaform
      • most common type of skin cancer
      • 1 in 3 in life
      • assoc. with sunlight or tanning or radiation exposure
      • 250,000 cases in U.S. per year
  • SCC
    • 2nd most common
    •  older individuals.
    • 2.1% mortality
    • treatment is shave, excise or desiccate

2. Melanoma, of which there are 5 kinds

  • superficial, nodular, lentigo, acral-lentiginous and amelanotic
  • Differential, or things that look like melanoma
    • Atypical nevi
    • seborrheic keratosis
    • AK, actinic keratosis
    • keratoacanthomas
    • Lentigo
    • dermantofibromas
    • sebaceous hyperasia
    • blue nevi
    • venous lakes800,000 individuals in U.S. have a history of melanoma.
  • fasting growing preventable cancer in U.S.
  • 9700 cases of Melanoma are related to tanning beds.
  • 8500 mortalities annually
  • related to sun, genetics, multiple nevi and atypical nevi individuals.
  • UVB is most potent ultraviolet light
  • 75% of adolescents, 33% of adults report at least one burn per year
  • UVA is also dangerous (tanning beds) and associated with photo aging, and cancer

Causes of skin cancer:


  • 20% increased risk of melanoma if ever used a tanning device
    • Double the risk if age 35 or younger
  • 1:6 h.s. kids admit to tanning bed use.
    • risk is cumulative,
    • Group 1 Carcinogen to humans (definite link)


Prevention of skin cancer:

Screening for skin cancer:

  • USPSTF, the U.S. preventive services task force
    • No recommendation for doctors to screen everyone
    • if you are high risk, tell your doctor.
      • examine thyself, and family
  • ABCDE’s of melanoma
    • Asymmetry
      • right side different from left
    • Border
      • irregular
    • Color
      • change
      • irregular
    • Diameter
      • >6 mm
    • Evolution
      • changing, looks different than all others

Special Cases:

  • Large congenital nevi have 5 % lifetime risk of M.
    • >20 cm


Dr. Rick Kellerman, Clinical Update
FP Essentials, Skin Cancer 10/2012

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