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

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.