What’s a cancerous skin lesion?

Prolonged exposure to the sun, heredity, skin type as well as chronological ageing are some of the factors that may cause a pre-cancerous skin lesion or even skin cancer. These lesions have different forms (basal cell carcominoma, squamous cell carcinoma or melanoma among others) and mainly develop in the face, the neck, the arms and the hands as well as the back. It is absolutely necessary to surgically remove cancerous skin lesions in order to diagnose and treat the cancer on time.

 

The main symptoms of basal cell carcinoma

This is the most common type of skin cancer (80%). Its clinical image is that of a small bump with definite border, slightly red colour and, in some cases red patches on its surface. It develops slowly but steadily and destroys the surrounding superficial and deeper tissues. It is located on the head and the neck by 75% and is metastatic by only a very small percent of 0, 05%.

 

The main symptoms of squamous cell carcinoma

This is the second most common type of skin cancer (15%-20%). Its clinical image is that of firm nodule with a sore, bleeding patch at the center. It is located on the head and the neck by 65%, but on other areas as well, on the legs and arms by 30% and on the torso by 5%. It develops by 80% as a result of actinic keratosis (precancerous lesions caused by prolonged exposure to the sun). It is a metastatic cancer by 5 % to 10% to the lymph nodes but remains a localised condition and has a low mortality rate.

 

The main symptoms of melanoma

 

It is considered to be the faster developing cancer in the world with 800.000 diagnosis every year. Early diagnosis with a full clinical overview based on particular morphological criteria and the use of dermoscopy has increased patients recovery from melanoma up to 98%. If melanoma is not diagnosed early and removed at the correct border or is at an advanced stage it is probably going to be metastatic. It develops by 30% to 40% on a preexisting melanocytic nevus while by 70% it develops without any preexisting skin lesion. You should take into consideration the following symptoms of a skin lesion in order for it to be suspicious: asymmetry, borders, diameter, thickness, family history, itching, bleeding, soreness, ulceration. Otherwise, according to the Glasgow system you should consider the following:

1. Change in size
2. Change in color
3. Change in shape
4. Diameter more than 7mm
5. Inflammation
6. Crusting/Bleeding
7. Sensory Change

 

The main factors linked to melanoma are

  • Family History
  • Dysplastic Nevi Syndrom -clinically visible atypical nevi
  • Large number of melanochromatic nevi
  • Skin type I and II, freckles, red hair
  • White Race and women
  • Clinically visible nevi that change
  • Sun burns and exposure to UV radiation
  • Immunosuppression
  • Giant congenital melanocytic nevi
  • Hyperpigmentation

Who’s a good candidate?

Cancerous skin lesions removal concerns all patients that have any skin lesion, regardless its form. Surgical removal is required for early diagosis as well as cancer treatment.

Facts I need to know

The doctor will examine the cancerous lesion thoroughly before proceeding with its removal. Cancerous lesions may have different forms and their surgical removal is a simple procedure performed under local anesthesia with excellent results. The doctor removes the lesion and part of the healthy tissue around it and then stitches the skin together. If a large part of skin tissue is removed she may use a skin graft, from another part of the body, to help the wound heal properly. The doctor comes across many cases of confirmed cancerous lesions and she then uses the technique of Mohs micrographic surgery during which she gradually removes layers of cancer tissue and examines them under the microscope until all cancer tissue has been removed. In this way she does not remove any healthy tissue around the lesion and she makes sure all cancer tissue has been removed.

Recovery Time

Patients return home immediately after the surgery. They notice redness and swelling on the area treated but symptoms fade in the next days. The doctor gives specific instructions for the wound care in order to avoid infections and to help patients recover quickly and safely.

Doctor’s Remarks

It is crucial to select a plastic surgeon with experience at skin lesions diagnosis as well as the appropriate removal method. It is also highly important to have the correct diagnosis and avoid useless or even harmful removals of lesions, with laser or cryoablation. Every suspicious lesion must be thouroughly checked by the doctor or even by a skin biopsy. I was trained in Skin Lesions surgery during my specialty time in the General Oncology Hospital Agioi Anargyroi where I dealt with several different cases.