MEDICAL DERMATOLOGY I SKIN CANCER
Skin cancer is the most common malignancy worldwide. The South African population is particularly at high risk of skin cancer due to the country's geographical position and level of ultraviolet radiation (UVR), as well as the increased sun exposure due to occupational and recreational activities.
There are 2 main categories of skin cancer - melanoma and non-melanoma. Melanoma (also known as "malignant melanoma") is less common than non-melanoma cancers but is the most dangerous type of skin cancer. Non-melanoma skin cancers are mainly comprised of "Basal Cell Carcinoma" (BCC) and "Squamous Cell Carcinoma" (SCC). BCC is the most common and the least dangerous type of skin cancer.
WHAT ARE THE SIGNS AND SYMPTOMS OF SKIN CANCER?
Skin cancer signs and symptoms include changes in size, shape, or colour of a mole or other skin lesion, the occurrence of new skin growth, or a sore that doesn't seem to heal. If you notice any spots on your skin that may be different from the others or skin changes, itching or bleeding, then it’s recommended to see a dermatologist.
HOW CAN A DERMATOLOGIST HELP?
- A dermatologist makes individual recommendations on how often a person needs a comprehensive skin examination depending on individual risk factors, such as skin type, history of sun exposure/damage and family history.
- People with a history of melanoma should have a comprehensive full-body examination by a dermatologist once a year, as well as regularly check themselves for new and changing moles.
The following ABCD-Easy rules show you a few changes that might indicate a 'melanoma', the deadliest form of skin cancer. These rules include:
- Asymmetry – this is when two halves of the area differ in shape.
- Border – this is when the edges of the area are irregular or blurred and sometimes show notches.
- Colour – this may be uneven and may be in different shades of black, brown and pink may be seen.
- Diameter – most melanomas are at least 6mm in diameter.
- Evolving – any spot that is changing in shape or colour. If in doubt, check it out!
If you see any of these changes on your skin, contact Dr Jacobs for an examination. Skin cancer screenings should be done annually to ensure early detection.
What to expect?
During your consultation, Dr Jacobs will do a comprehensive skin examination that covers from head to toe to ensure any potential skin cancers are identified. Specialised equipment called a dermatoscope is used for magnification and evaluation of potential tumours. A dermoscopy helps promote early detection of skin cancer. If a lesion is concerning, then there may be a need for a skin biopsy. Dr Jacobs will perform the biopsy under local anaesthetic, and the tissue sample taken will be sent to the laboratory for histological assessment.
PRECANCEROUS SUN SPOTS OR ACTINIC KERATOSES
Actinic keratoses are rough, scaly patches of skin due to sun damage. They are predominantly found on sun-exposed parts of the body, particularly the forearms, backs of the hands, face, ears, bald scalp and lower legs.
Actinic keratoses are normally caused by cumulative sun exposure over the years, which may be due to recreational activities or working outside, as well as sunbathing or sunbed use. The condition is more common in older people. Left untreated, there is a very small risk that an actinic keratosis can progress into a form of skin cancer called squamous cell carcinoma. That's why it's important to visit a dermatologist to know if you have any of these precancerous growths on your skin.
Actinic keratoses vary in appearance but can simply feel rough or scaly, looking like dry skin, and may be itchy, bleeding or crusting. They are often pink but can be skin coloured or red.
Dr Jacobs will do a comprehensive skin examination to determine the number and location of actinic keratoses as the treatment depends on how many you have. Treatment of actinic keratoses may include several types of prescription creams for use at home. These include 5-fluorouracil or imiquimod, which are effective treatments and also daylight photodynamic therapy.
Cryotherapy, which involves freezing the actinic keratoses in order to remove them, is another common treatment for actinic keratoses. During cryotherapy, Dr Jacobs sprays the AK with extremely cold liquid nitrogen. The treated skin tends to peel off within a few days to a few weeks. When your skin heals, you’ll see new, healthy skin which may look a bit lighter than surrounding skin.
