Medical Dermatology / Evaluation

Skin Cancer

istock_000016942266xsmallIn the United States there are over 5 million new cases of skin cancer diagnosed every year, which is more than cancers of the breast, prostate, lung and colon combined.  One in five Americans will develop skin cancer in their lifetime, and the incidence of melanoma, the deadliest form of skin cancer, has been steadily increasing over the past 40 years.

The cause of skin cancer is damage to the cellular DNA. The majority of the time this is induced by ultraviolet light, either from the sun or from tanning bed exposure. Those who are fair skinned, have blond or red hair, have a history of excessive sun exposure, and those who have used tanning beds are at increased risk of skin cancer. People whose immune systems are suppressed by medications, cancers, or organ transplantation experience higher rates of skin cancer as well.

These are the three main types of skin cancer in order of prevalence:

  • Basal Cell Carcinoma – BCC arises from the cells in the deepest layer (the base) of the epidermis.  It is a slow growing cancer that only rarely spreads from the original location to become life threatening.  It appears as a pearly white, pink or red growth.  It will occasionally resemble a scar and may bleed easily.  Many people do not realize they have a BCC until it has been there for quite some time.
  • Squamous Cell Carcinoma – SCC arises in the cells of the upper epidermis; the layer on the surface of the skin.  It is generally slow growing but may metastasize from particular locations, or if it is left to grow for some time.  It appears as a scaly patch, open sore, or elevated growth that crusts or bleeds.
  • Melanoma – arises from the melanocytes, the pigment-producing cells of the skin.  It can appear in normal skin or within a pre-existing mole. The majority of melanomas are black or brown, but they can also be skin-colored, pink, red, blue or white.  With early detection, melanoma is a highly curable cancer but these tumors can be aggressive once they begin to invade the skin.

Early detection is key for all types of skin cancer.  At the Center for Dermatology & Laser Surgery, we believe that regular full skin exams, at intervals appropriate to a patient’s age, risk factors and family history, are vital in minimizing the incidence and harmful effects of skin cancer. All our providers are trained in dermoscopy, a method in which we use a tool to magnify and evaluate skin growths. Dermoscopy has quickly become the standard of care for differentiating benign skin growths from those that are potentially cancerous.  If you have a concerning growth, please schedule an appointment to have it evaluated by one of our skilled providers.

 

Mole Evaluation

A mole is a common, benign growth composed of melanocytes, the pigment-producing cells in the skin.  A mole may be present at birth or appear later in life.  Non-pigmented moles exist and may appear pink, red or flesh-colored. If they contain the pigment melanin, they may display brown, black or blue color. Fair-skinned individuals tend to have more moles than those with darker skin. They may appear anywhere on the body including the scalp, palms, soles and genitals. Heredity and sun exposure will both determine the number and type of moles to appear on a person’s skin.

While the vast majority of moles are benign and remain that way over an individual’s lifetime, some do progress to become melanoma, a type of skin cancer. It is important to monitor moles for changing appearance and behavior over time. A useful tool for monitoring moles for suspicious characteristics is the ABCDE method:

  • Asymmetry: If you draw a line through the mole, the two halves do not match.
  • Border: Uneven or notched border as opposed to a smooth one.
  • Color: Different shades of brown, black, blue, pink and/or white in the same mole.
  • Diameter: Greater than 6 mm, or the size of a pencil eraser.
  • Evolving: Rapid changes in the above characteristics.

Other features that may be cause for alarm would be a bleeding or tender mole, a mole that does not resemble others found on the same person, and a new mole in someone over the age of 40.  Melanoma may develop in a mole that has been present for many years, or it may spontaneously develop in an area of normal skin. Regular self-skin exams are recommended so new and changing growths can be more easily identified.  If you have a large number of moles, moles in areas that you cannot see, or if you have a family history of melanoma, regular skin exams by a dermatology provider are also recommended.

At the Center for Dermatology and Laser Surgery, all our providers are trained in dermoscopy, a method in which we use a tool to magnify and evaluate skin growths. Dermoscopy has quickly become the standard of care for differentiating benign moles from those that are potentially cancerous. In some cases, a biopsy is necessary to rule out melanoma.  Biopsies can be quickly and easily performed, usually on the same day as the initial evaluation. If you have a concerning mole, please schedule an appointment to have it evaluated by one of our skilled providers.

Rashes

Woman Scratching Her Arm Sitting on Bench at ParkRashes are eruptions in the skin that can take many different forms. Redness, itching and scaling are the most common symptoms that one may experience, however burning, pain, blisters, pustules, weeping, and welts may also occur. Some rashes have an infectious cause, some are due to allergic reactions, and others may be a symptom of an underlying medical condition. Here is a list of the most common rashes we encounter at the Center for Dermatology and Laser Surgery:


  • Poison oak/Poison ivy
  • Eczema/Atopic dermatitis
  • Psoriasis
  • Seborrheic dermatitis
  • Pityriasis rosea
  • Perioral dermatitis
  • Scabies
  • Diaper rash
  • Ringworm/Athlete’s foot
  • Lichen planus
  • Medication reactions
  • Allergic contact dermatitis
  • Lupus
  • Hives
  • Shingles
  • Herpes virus eruptions
  • Folliculitis

In many cases, a rash may be diagnosed through physical examination alone, however there are many tools available to aid in correctly identifying a skin eruption. These would include skin biopsies, cultures for bacteria, fungi and viruses, microscopic examination of skin scrapings, and blood tests. If you are experiencing a troubling rash, please schedule with a medical provider for evaluation. Urgent appointments are available for those suffering from rapidly evolving or extremely uncomfortable eruptions.

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