Skin Cancer: Etiology & Diagnosis

In 2011, over 960,000 Americans were living with melanoma and approximately 2.1 percent of individuals will be diagnosed with melanoma at some point in their life (seer.cancer.gov). While these numbers may seem extremely low, the numbers continue to increase annually.

 

Skin

 

Our skin is the biggest barrier against germs and bacteria. The skin contains three layers.

Epidermis is the outermost layer, which contain keratinocytes (skin cells). This layer protects neurons (nerve cells), muscles, and internal organs from trauma.

Stratum Corneum outer layer of the epidermis. This very tough, waterproof overcoat is vital in preventing chemicals, viruses, and bacteria from entering the human body.

Stratum Lucidum is a translucent layer of dead skin cells

Stratum granulosum cells begin to die here, as they move farther away from nutrients

Stratum Spinosum layer contains Langerhans cells (antigen-presenting cells), which are responsible for preventing antigens from entering through the skin.

Stratum Basale is the innermost layer, which contains melanocytes. The melanocytes produce pigment melanin and are mainly responsible for filtering out UVR (ultra violet radiation).

Dermis is the middle layer of skin, which contains blood and lymphatic vessels, sensory nerve ending, sebaceous glands, hair follicles, and smooth muscles.

Capillary layer of the dermis contains dermal papillae, which is located on the bottom of hair follicles. This is also where the sensory perception and capillaries. These cells are responsible for the formation, growth, and cycling of hair. Papilla creates fingerprints.

Reticular layer is by far the thickest layer of skin. It contains mostly collagen, elastin, and reticular fibers.

Subcutaneous tissue is basically a layer of fatty tissue, which is located underneath the dermis.

 

Actinic Keratosis

 

Actinic keratosis is known as pre-cancerous. The skin becomes rough and scaly, which is caused from excessive sun exposure and should be treated by a dermatologist. These are very commonly found on the skin that is often left uncovered by clothing including the arms and facial area. Individuals that are fair skin are at higher risk for getting actinic keratosis, which may turn into squamous cell carcinoma at some point, if left untreated.

Diagnosis normally involves a skin biopsy.

Treatment can range from cryotherapy (freezes actinic keratosis) to curettage (surgical procedure to remove the affected tissue).

 

Melanoma

 

Melanoma has by far surpassed other types of skin cancer, in that it is the most dangerous. It is pertinent that these malignant growths are attended to, as soon as they are noticed. Melanoma tumors begin in the melanocytes and often develop from a simple mole. Excessive exposure to UVR, with frequent sunburns is the most common cause, but those that are genetically predisposed are at a higher risk.

 

Signs And Symptoms

 

When you first notice an abnormal looking mole, you should begin your very own diagnosis by using the ABCDE rule. This is not to say that you should not follow up with your primary care physician or dermatologist, but only to give you an idea of what to look for.

Asymmetry- one side of the mole is entirely different than the other.

Border- irregular or notched

Color- is a mixture of brown or black, with an occasional pink, red, white, or blue.

Diameter- larger than six millimeters in width.

Evolving- continuously changing its size, color, and shape.

 

Staging Of Melanoma

 

Stage 0- the epidermis contains abnormal melanocytes.

Stage I- malignancy is formed and the tumor is no thicker than 1 millimeter, with no ulceration (breaks in the skin).

Stage II- the tumor is thicker than 1 millimeter, but not thicker than 2 millimeters, with ulcerations or the tumor is thicker than 4 millimeters with no ulceration.

Stage III- the malignant tumor may be any thickness and has metastasized to the lymph nodes.

Stage IV- the malignancy has metastasized to other body organs, soft tissue, and possibly the gastrointestinal tract.

Other things to look for are non-healing sores and unusual lumps or blemishes.

 

Treatment For Melanoma

 

The treatment for melanoma will depend on the stage that it is diagnosed. If the malignancy is in the third and fourth stage the prognosis will be very low.

Surgery to remove the malignant tumor

Surgery may be followed up with chemotherapy and radiation therapy

Biologic Therapy is very effective in treating melanoma. This type of treatment involves using the individual’s immune system, which will slow the tumor grown, reduce its size, and possibly kill the cancer cells.

Targeted therapy focuses on the use of drugs and other substances to kill the malignant cells.