SKIN ONCOLOGY

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Skin tumors are generally divided into three categories.

The basal cell carcinomas (BCC) generally present as a skin lesion, usually on sun-exposed areas of the face and less frequently in the rest of the body. They usually appear after the fifth decade and in people exposed to the sun without protection due to an outdoor occupational activity (farmers, fishermen, construction workers). Most recently BCC have started appearing in younger ages, largely due to the thinning of the Earth’s ozone layer. Sun protection is of great importance particularly to fairer people.

A skin lesion with certain qualities such as a lump, of skin color, with neoplastic vessels and possibly a central ulceration that doesn’t go away should make us visit our doctor. The solution is surgical resection and histological examination of the lesion in order to be certain about its histology and whether we have completely resected it. Thermocoagulation therapy, cryotherapy or ointments are prohibited, especially without histologic control. The basal cell carcinomas are the most benign, do not metastasize and in case of partial treatment we usually have to extend the radius and/or depth of the resection. If fully resected and with tumor free histological boundaries the lesion is considered fully healed.

The second category of skin lesions are the squamous cell carcinomas (SCC), which exhibit a more aggressive behavior and give metastases in adjacent lymph nodes. They present as ulcerations especially on lips, trunk and extremities. They require surgical removal as rapidly as possible, radiotherapy and possibly chemotherapy.

Finally melanoma is a malignant lesion of the skin, mucosa and even of the retina. It is possible to be detected in any area of the body in healthy skin or formerly present pigmented nevus. As general information, the public should know that when new nevi appear (8 times out of 10 melanoma occurs without preexisting lesion) or an lesion changes shape, color and size they should visit a specialist (plastic surgeon or dermatologist).The acronym ABCDE applies, which helps to educate the public.

A: asymmetry, namely the asymmetry of the lesion.
B: Border, that is the border of the lesion, is uneven and laced.
C: color, the color is not uniform but has different colors.
D: diameter, that the diameter is greater than 6mm.
E: Evolution i.e. the evolution if the damage was recently changed to aforementioned elements.

With early diagnosis and surgical treatment, when the damage is still superficial and thin, melanoma is cured completely.