ABCD CRITERIA FOR MALIGNANT MELANOMAA = asymmetry; halves do not match
B = borders; edges are irregular or vague
C = color; two or more colors are present
D = diameter; larger than one quarter inch
Symptoms and Diagnostic Path
Symptoms vary among the types of skin cancer,
though generally any wound or sore that does not
heal or mole that changes appearance is suspect.
The diagnostic path typically includes biopsy of
suspicious lesions. The dermatologist may remove
very small lesions without biopsy, as doing so
effectively removes any cancer that is present.
Biopsy identifies the type of cancer present, which
determines the appropriate course of treatment.
CHARACTERISTIC SKIN CANCER SYMPTOMSType of Skin Cancer Characteristic Symptoms
basal cell carcinoma sore that does not heal
persistent red or flaky patch
that itches
shiny, discolored NODULE
vascular crater
yellowish, waxy, itchy plaque
squamous cell carcinoma wartlike lesion that bleeds
flaky patch that bleeds
sore that repeatedly bleeds
and crusts
lip ulceration that does not
heal
malignant melanoma ABCD criteria:
- asymmetrical appearance
- irregular borders
- multiple colors
- diameter greater than one
quarter inch
Treatment Options and Outlook
The preferred treatment for nearly all skin cancer
is surgical removal, which may include various
methods such as curettage and electrodesiccation
(scraping and cauterization), excision (cutting
out), and MOHS’ MICROGRAPHIC SURGERY. Micro-
scopic examination of the removed LESION con-
firms the diagnosis and type of cancer. Malignant
melanoma requires extensive excision, with wide
margins and possible removal of nearby LY M P H
NODES, and may require follow-up CHEMOTHERAPYif
the cancer has metastasized. Dermatologists may
use cryotherapy (liquid nitrogen) to remove pre-
cancerous lesions, such as those of actinic kerato-
sis, and very small lesions that appear suspicious.
Other treatment options may include topical
imiquimod (Aldara) cream and RADIATION THERAPY.Risk Factors and Preventive Measures
The single-most important risk factor for skin can-
cer is excessive sun exposure. People born before
the 1980s have the highest risk for skin cancers
because they grew up before sunscreen products
became available. Skin cancers tend to manifest
several decades after the exposures that damaged
the skin, making it important for people age 40
and older to have yearly skin examinations from a
physician and to perform monthly SKIN SELF-EXAMI-
NATION. People who have had skin cancers
removed may need more frequent physician eval-
uation. The most effective preventive measures
are those that safeguard the skin from sun dam-
age. These measures include- limit sun exposure during peak ultraviolet
intensity (10 a.m. to 2 p.m. in most of the
United States) - wear protective clothing to cover the skin
- apply sunscreen liberally and frequently before
and during sun exposure
See also CANCER RISK FACTORS; CANCER TREATMENT
OPTIONS AND DECISIONS; KERATINOCYTE; MELANOCYTE.skin replacement A procedure for restoring SKIN
to areas of the body where there has been exten-
sive damage and loss of skin. BURNS, major
trauma, surgery, varicose ulcers, and decubitus
ulcers are among the conditions that require skin
replacement. Skin-replacement techniques may
use skin grafts or synthetic skin products for tem-
porary or permanent reconstruction.Skin Grafts
There are three main sources for skin grafts:- autograft, which harvests skin from one loca-
tion on the person’s body and transplants to
another for permanent skin replacement
198 The Integumentary System