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Monday
May302011

Hey Doc, this spot just keep coming back, do you think I should take it off?

So, do you have a spot on your skin that has been there for a while?  Is it changing? Is it getting a sore?  Are people telling you that you should have it looked after (men this would be you wife)?  Well, maybe they are right; maybe it is something to be a bit more worried about.  If you have a spot on your skin that just keeps getting bigger and is changing, especially if it an area that gets a lot of sun, it should be seen, and possibly removed.  Last week we talked about the type of skin lesions that were not cancer, and this week we will start talking about skin cancers.

I have this spot that just won’t heal, what is it?  On sun exposed skin, if you have a spot that just does not seem to heal, then that is something to have seen.  The most common areas for Squamous Cell skin cancer are the face (especially lips and nose), neck, and back of the hands.  Often it is tender, has a lot of scale or crust to it, hay have a hard horn coming out of it, or have a shallow ulcer in the center.   The only way to be certain of the diagnosis is to biopsy the spot, which may also be a cure as well (Lancet 2010).

Why do people get these things? There are many risk factors that are associated with skin cancers, but the biggest one is the sun.  Ultraviolet radiation (from the sun or other sources) can cause damage to the DNA in the skin cells.  This leads to mutations that can become cancers.  There are other things that can do this as well (radiation, infrared, arsenic, some hydrocarbons, human papillomavirus and some skin diseases).  As well there are some industrial agents that can cause problems with long term exposure (Lancet 2010).

Well, it is just a small thing why make a fuss?  Unfortunately, Squamous Cell skin cancer has the potential to spread to distant locations (i.e. metastasize).  The likelihood of it spreading is dependent on several factors: size >2 cm, thickness, where it is located (central face worst) and the type of cells seen on biopsy (Lancet Oncology 2008).

Ok, so how do we treat it? The best treatment is surgical removal of the skin cancer.  There are a couple of different surgical techniques that are used, but in the end, cutting it out is the way to go.  When the surgery is performed, the goal is to take a little extra normal skin around the cancer so you can make sure you have gotten it all (Nature. Clinical Practice Oncology 2007).

Is there anything I can do to prevent it?  Sunscreen is effective in the prevention of Squamous Cell skin cancers.  That is the rub on sun screen, the higher the SPF rating the better (Lancet 1999).  It is also worth wearing protective clothing and a hat to help provide shade to the high risk areas such as the face, neck and hands (National Guidelines Clearing House 2009).

For more information on skin cancer look here.

For more information on sun safety look here or here 

 

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    Hey Doc, this spot just keep coming back, do you think I should take it off? - What's Happening In Clinic - O'Leary Health Center
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    Response: Dr Zizmor
    Hey Doc, this spot just keep coming back, do you think I should take it off? - What's Happening In Clinic - O'Leary Health Center
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    Hey Doc, this spot just keep coming back, do you think I should take it off? - What's Happening In Clinic - O'Leary Health Center
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    Hey Doc, this spot just keep coming back, do you think I should take it off? - What's Happening In Clinic - O'Leary Health Center
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    Hey Doc, this spot just keep coming back, do you think I should take it off? - What's Happening In Clinic - O'Leary Health Center
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    Hey Doc, this spot just keep coming back, do you think I should take it off? - What's Happening In Clinic - O'Leary Health Center
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