Skin Cancer in People of Color

What You Need to Know

It’s a fact: Skin cancer affects people of all colors. Even if you have a darker skin tone, always tan or rarely burn, you can still develop the disease. What’s more, for people of color, skin cancer is often diagnosed later, when it is harder to treat. This includes people of African, Asian, Latino, Mediterranean, Middle Eastern and Native American descent.

Simply put, if you have skin, you can get skin cancers. These include the nonmelanoma skin cancers like basal cell carcinoma (BCC), squamous cell carcinoma (SCC) as well as melanoma. Furthermore, ultraviolet (UV) radiation from the sun can cause dangerous, lasting damage to your skin.

What People of Color Can Do

The most important thing to do is get to know your skin type and protect your skin from the sun. Also, check yourself monthly and see a dermatologist once a year for a full body exam. No matter what, if you notice anything NEW, CHANGING or UNUSUAL on your skin, contact a dermatologist.

Skin of Color Stats

• Skin cancer represents 1 to 2 percent of all cancers in Black people.²
• Skin cancer represents approximately 2 to 4 percent of all cancers in Asian people.²
• Skin cancer represents 4 to 5 percent of all cancers in Hispanic people.³
• Squamous cell carcinoma is the most common skin cancer in Black people.²
• Black patients with melanoma have an estimated five-year melanoma survival rate of 70 percent, versus 94 percent for white patients.¹
• Melanoma in people of color most often occurs on areas that get little sun exposure. Up to 60 to 75 percent of tumors arise on the palms of the hands, soles of the feet under the nail (subungual) and the nail areas. ²
• Black patients are more than three times as likely to be diagnosed with melanoma at a late stage than non-Hispanic white patients. 52 percent of non-Hispanic Black patients and 26 percent of Hispanic patients receive an initial diagnosis of advanced-stage melanoma, versus 16 percent of non-Hispanic white patients. ⁴
• In nonwhites, the plantar portion of the foot is often the most common site of skin cancer, being involved in 30 to 40 percent of cases.³
• People of color have higher percentages of acral lentiginous melanoma (ALM, melanoma of the palms, soles and nailbeds) than Caucasians. Superficial spreading melanoma is the most frequent subtype in Caucasians and Hispanics.³

Click for references

1. Cancer Facts and Figures 2023. American Cancer Society. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2023/2023-cancer-facts-and-figures.pdf  Accessed January 16, 2023.
2. Gloster HM, Neal K. Skin cancer in skin of color. J Am Acad Dermatol 2006; 55:741-60.
3. Bradford, Porcia T. Skin Cancer in Skin of Color. Dermatol Nurs 2009 Jul-Aug; 21(4): 170-178.
4. Hu S, Soza-Vento RM, Parker DF, et al. Comparison of stage at diagnosis of melanoma among Hispanic, black, and white patients in Miami-Dade County, Florida.  Arch Dermatol 2006; 142(6):704-8.

Bob Marley was diagnosed with acral lentiginous melanoma (ALM) which ultimately claimed his life in 1981 at age 36. When a dark spot appeared under his toenail, Marley attributed it to a soccer injury. Eventually he was diagnosed with the disease but was not treated. His melanoma spread to other areas of his body and tragically cut his life short.

Ask the Expert

Q: While all types of skin cancer are less common in people of color, their outcomes are dramatically worse. What accounts for this gap?

A: Skin cancers are less prevalent in nonwhite racial ethnic groups, but when they occur, they tend to be diagnosed at a later stage. As a result, the prognosis is worse. One study showed that late-stage melanoma diagnoses are more common in Hispanic and Black patients than in non-Hispanic white patients.

First, there’s a lower public awareness of the risk of skin cancer among individuals of color. Second, from the perspective of health-care providers, there’s often a lower index of suspicion for skin cancer in patients of color. This is because the chances of it are smaller. So these patients may be less likely to get regular, full-body skin exams. And third, the places on the body where skin cancers tend to occur in people of color are often in less sun-exposed areas. This makes detection more difficult. For example, the most common location for melanoma in patients of color is the lower extremities — the soles of the feet in particular. [Read full blog post: Is There a Skin Cancer Crisis in People of Color?]

– Andrew Alexis, MD, MPH, is chair of the Department of Dermatology at Mount Sinai St. Luke’s and Mount Sinai West in New York City.

Images

Please note: Since not all skin cancers have the same appearance, these images serve as a general reference to what it may look like.

ACRAL LENTIGINOUS MELANOMA

Acral lentiginous melanoma (ALM) is the most common melanoma found in people of color.

Photo credit: Hugh Gloster, MD

BASAL CELL CARCINOMA

A basal cell carcinoma (BCC) may be pigmented, like this one, on skin of color.

Photo: Andrew Alexis, MD, MPH

Pigmented BCC

Photo: Hugh Gloster, MD

Pigmented BCC behind the ear

Photo: Hugh Gloster, MD

BCC on the nose of an Asian man

Photo: Hugh Gloster, MD

SQUAMOUS CELL CARCINOMA

Squamous cell carcinoma (SCC) on the scalp of a Black man.

Photo: Hugh Gloster, MD

Last updated: December 2022

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Melanoma Stages – The Skin Cancer Foundation

How is melanoma diagnosed?

To diagnose melanoma, a dermatologist biopsies the suspicious tissue and sends it to a lab, where a dermatopathologist determines whether cancer cells are present.

After the disease is diagnosed and the type of melanoma is identified, the next step is for your medical team to identify the stage of the disease. This may require additional tests including imaging such as PET scans, CT scans, MRIs and blood tests.

The stage of melanoma is determined by several factors, including how much the cancer has grown, whether the disease has spread (metastasized) and other considerations. Melanoma staging is complex, but crucial. Knowing the stage helps doctors decide how to best treat your disease and predict your chances of recovery.

• I’ve been diagnosed with melanoma. What happens next?
• What are the melanoma stages, and what do they mean?
• What happens after staging?

I’ve been diagnosed with melanoma.

What happens next?

Doctors use the TNM system — developed by the American Joint Committee on Cancer (AJCC) — to begin the staging process. It’s a classification based on three key factors:

T stands for the extent of the original tumor, its thickness or how deep it has grown and whether it has ulcerated.

What Is Breslow depth?

Breslow depth is a measurement (in millimeters) from the surface of the skin to the deepest component of the melanoma.

Tumor thickness: Known as Breslow thickness or Breslow depth, this is a significant factor in predicting how far a melanoma has advanced. In general, a thinner Breslow depth indicates a smaller chance that the tumor has spread and a better outlook for treatment success. The thicker the melanoma measures, the greater its chance of spreading.

Tumor ulceration: Ulceration is a breakdown of the skin on top of the melanoma. Melanomas with ulceration are more serious because they have a greater risk of spreading, so they are staged higher than tumors without ulceration.

N indicates whether or not the cancer has already spread to nearby lymph nodes. The N category also includes “in-transit” tumors that have spread beyond the primary tumor toward the local lymph nodes but have not yet reached the lymph nodes.

M represents spread or metastasis to distant lymph nodes or skin sites and organs such as the lungs or brain.

After TNM categories are identified, the overall stage number is assigned. A lower stage number means less progression of the disease.

What are the melanoma stages, and what do they mean?

Early melanomas

Stage 0 and I are localized, meaning they have not spread.

• Stage 0: Melanoma is localized in the outermost layer of skin and has not advanced deeper. This noninvasive stage is also called melanoma in situ.

• Stage I: The cancer is smaller than 1 mm in Breslow depth, and may or may not be ulcerated. It is localized but invasive, meaning that it has penetrated beneath the top layer into the next layer of skin. Invasive tumors considered stage IA are classified as early and thin if they are not ulcerated and measure less than 0.8 mm.

Find out about treatment options for early melanomas.

Intermediate or high-risk melanomas

Localized but larger tumors may have other traits such as ulceration that put them at high risk of spreading.

• Stage II: Intermediate, high-risk melanomas are tumors deeper than 1 mm that may or may not be ulcerated. Although they are not yet known to have advanced beyond the primary tumor, the risk of spreading is high, and physicians may recommend a sentinel lymph node biopsy (SLNB) to verify whether melanoma cells have spread to the local lymph nodes. Thicker melanomas, greater than 4.0 mm, have a very high risk of spreading, and any ulceration can move the disease into a higher subcategory of stage II. Because of that risk, the doctor may recommend more aggressive treatment.

Learn more about sentinel lymph node biopsy and melanoma treatment options.

Advanced melanomas

Spread beyond the primary tumor to other parts of the body. There are also subdivisions within these stages.

• Stage III: These tumors have spread to either the local lymph nodes or more than 2 cm away from the primary tumor through a lymph vessel but not yet to the local lymph nodes. Thickness no longer plays a staging role. If local lymph nodes are palpable, meaning they feel enlarged when examined by a doctor, the tumor has reached them, and they are removed. Sometimes melanoma is present even in lymph nodes that are not palpable.
• Sentinel lymph node biopsy (SLNB) is a technique used to determine whether the disease has spread to one or more nearby lymph nodes. Melanomas that have spread to very small areas of nearby skin or underlying tissue but have not reached the lymph nodes are known as “satellite tumors” — and are also included in stage III. The staging system includes metastases so tiny they can be seen only by microscope (micrometastases). The degree of disease advancement depends on whether the tumor has reached the nodes, the number of nodes involved, the number of cancer cells found in them and whether they are microscopic or are palpable and can be seen with the naked eye.

• Stage IV: The cancer has advanced to distant body areas, lymph nodes or organs, most often the lungs, liver, brain, bone and gastrointestinal tract. The two main ways to determine the degree of advancement in stage IV melanoma are the site of the distant tumors and the presence of elevated serum lactate dehydrogenase (LDH) levels. LDH is an enzyme that turns sugar into energy; the more found in blood or body fluids, the more damage has been done.

These stages are each further broken down, from lowest to highest risk, depending on different characteristics of the original tumor and the areas where it has spread.

Cancer staging can be complex and confusing. If you have been diagnosed, ask your doctor to explain your stage in a way you can understand.

What happens after staging?

Once your melanoma stage is determined, your doctor will develop a treatment plan that’s best for you.

Learn more about melanoma treatment options.

Reviewed by:
Allan C. Halpern, MD
Ashfaq A. Marghoob, MD
Ofer Reiter, MD

Last updated: September 2020

This section made possible through an education grant from

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Skin growths

Most of us have skin growths of some kind. It can be moles, warts, etc. Some stay with us for life, while others require removal. And not only because some of them look unattractive as it may seem. But also because they can cause harm to health and even become a threat to human life. But do not be afraid, but you need to pay attention to your skin and visit a good dermatologist in order to ensure prevention and eliminate dangerous neoplasms in time. Let’s talk about the most common skin elements – moles and warts.

Warts are benign tumors caused by the human papillomavirus. This virus can be transmitted. The human papillomavirus can manifest itself in the form of warts on the skin, it can cause cancer of the genital organs in women and men. Sometimes a dangerous virus lives in the body for years, but if the immune system fails, it can lead to oncology. Therefore, warts must be removed. But you need to do this in the doctor’s office, and not at home on your own. You can’t remove warts on your own.

Modern cosmetology can eliminate papillomas with a laser. A special laser beam burns out the wart from the root, and normal healthy skin remains in its place. The procedure is performed under local anesthesia, so it is painless. The entire session takes 2-3 minutes. A small crust will appear on the laser-treated area, which will disappear within 14 days.

Moles are another element on the skin that is not as harmless as it seems. Some of them need to be removed as they can lead to melanoma, a skin cancer. A mole is made up of melanocytes, a brownish pigment produced by the skin. Uncontrolled division of these cells leads to oncology. They can begin to share intensely for various reasons. For example, if a mole is constantly injured. But not all moles are dangerous. There are those with whom you can live in peace all your life and not be afraid that they will lead to oncology. When should you be concerned? There are several signs in which you should definitely visit a doctor:

1. Draw a horizontal axis through the middle of the mole. The mole should split into two equal halves. If these halves are uneven, then this is the reason for visiting a dermatologist.

2. The mole should have smooth edges. If the edge is uneven, there are notches, then perhaps there is a rebirth.

3. If the color of the mole is uneven, there are inclusions of a different color, then this is the third sign.

4. If your mole is growing. The larger it is, the more carefully it must be monitored. People with large birthmarks are at risk. It is also necessary to be observed if you have small moles, but in large numbers.

5. If the mole has dynamics, that is, it increases in size, bleeds, crusts appear on it, then it is necessary to examine it.

Some people don’t need to worry about moles, others are at risk. How can you tell if you’re at risk for melanoma? Of course, the first thing to do is to consult a doctor. You also need to know the following:

– People who have 50 or more moles are at risk. Since there are many of them, it is likely that one of them may begin to be reborn. Therefore, every year it is necessary to be examined by a specialist. People with a family history of melanoma should see a dermatologist annually.

– The second group includes representatives of Scandinavian origin. These people have blond hair, blue, green or gray eyes. In addition, there may be many freckles. The owners of this appearance genetically had to live closer to the pole and when they move to countries with a warmer climate, their skin is not protected from the aggressive influence of the sun. It is sensitive to ultraviolet radiation and there is a risk of degeneration of moles.

– Those who have dysplastic nevi on their bodies are also at risk of oncology. Dysplastic nevi are moles that resemble fried eggs. In the center of such a mole there is a dark core, and around it there is a lighter pigment. People with dysplastic nevi are at risk 50 times more than people with normal moles.

– You should also see a dermatologist if you have a congenital large birthmark. Especially if there are no hairs on it.

For examination of neoplasms, it is necessary to consult a dermatologist. You can also make an appointment with a dermato-oncologist – a doctor who specializes in the treatment of malignant tumors.

Before a mole is removed, a special lab test is required to determine if your mole is normal and you don’t have to worry about it, or if it’s a new growth that needs special attention. Within 10 days after such an analysis, you must receive a doctor’s report, where the diagnosis will be made. In accordance with this diagnosis, the doctor prescribes further treatment tactics.

In our Clinic, we perform examination and removal of most skin lesions. There are a large number of their types. We remove moles, papillomas, keratomas, hemangiomas, skin horns, atheromas, dermatofibromas, condylomas, xanthomas, molluscum contagiosum, milia, etc. Elimination of skin neoplasms is carried out on the Surgitron apparatus by the radio wave method. The procedure is fast and painless. You won’t feel any discomfort as doctors use local anesthesia. The skin is practically not injured and the recovery period is minimal. By removing the neoplasm, you can return to the usual rhythm of life.

Call us today and make an appointment with a highly professional specialist of our Clinic. We will help you get rid of skin neoplasms quickly and painlessly.

Moles: dispelling fears | clinic blog Nashe Vremya

Any stories about moles are covered with many myths and fears. Most of them are associated with an increased risk of skin cancers. There are also those who are frightened by the transformation of harmless formations into malignant melanoma even with a single visit to the solarium.

Often, all experiences turn out to be groundless, because not all moles turn into melanoma. You can save yourself from extremely unpleasant consequences if you notice a variety of spots and irregularities in time, learn how to respond to them correctly.

What are nevi

The medical name for birthmarks is nevi. These benign formations on the skin, mucous membranes and iris of the eye are formed from cells that contain the pigment melanin. Normally, it absorbs ultraviolet rays and protects against burns.

Moles are distinguished from each other by form :

• round
• oval
• rectangular
• “torn”, etc.

They also differ in location on the skin :

• tower over her
• are on the same level as
• form around hairs, etc.

Mole color depends on the excess or lack of melanin. In the human body, it is of three types:

• eumelanin – responsible for black and brown shades
• pheomelanin – pink and red
• neuromelanin – while being studied, it is low in the substantia nigra of the brain in patients with parkinsonism

Depending on the type of melanin moles acquire different colors :

• brown
• black
• purple
• blue
• yellow etc.

In addition to melanin, they may include hemoglobin and keratin.

With an increased amount of hemoglobin, a mole can be easily confused with a thrombosed vessel. A dermatologist sees it during a routine examination. The Dermatoscope helps to distinguish a raised black dot from melanoma. Through it, the doctor notices numerous blood clots in the hemangioma. Similar “red moles” sometimes appear in adults.

The presence of keratin protein gives white and orange blotches. Seborrheic keratoma is not related to skin cancer. It looks like a spot on the skin with a sticky crust and never turns into melanoma. It is necessary to remove it only when severe itching or an unaesthetic appearance appears.

Symptoms

At the sight of a newly appeared mole, the question naturally arises whether it is cancer. The problem has a solution from several actions. The first of them is a careful examination and detection of characteristic symptoms:

• Presence of pain . Depending on the type of neoplasm, any sensations may be absent or itching, tingling around the mole, burning may bother you.
• Hair growth at the top of the mole. They do not cause discomfort, they can suddenly disappear.
• Color and borders education. You need to pay attention to the uniformity of staining, the presence of lightened or darkened areas.
• Growth rate . Once having arisen, the mole practically does not change its original size.
• Redness of the surrounding skin. Inflammation without previous trauma often accompanies a formation that often occurs.
• Enlarged lymph nodes . The condition of the lymphatic tissue in the surrounding areas is determined by the doctor. An ordinary mole does not cause any changes in them.
• Presence of signs of chronic malaise . Excessive fatigue, fever, headache, occasional or persistent nausea, weight loss, combined with unusual skin symptoms – a reason to visit a doctor.

Causes

With moles on the body, people are often born. They talk about congenital skin formations if they appear in early childhood (up to 3 years). Acquired ones are formed later. Often, “guests” on the skin are noticed at an older age. Usually the appearance of moles is associated with puberty in adolescents.

There is no need to panic here right away: the activity of hormones increases, and brown spots on the skin are already appearing.

There is a direct relationship between moles, freckles and bright sunlight: the more sunlight hits open areas of the skin, the more likely it is to have numerous marks on it – barely noticeable dark pigment spots or moles.

A large number of small neoplasms often accompanies diseases of the endocrine system – diabetes, obesity.

Moles are also inherited. In mother and child, they are sometimes formed in the same places and in the same quantities. Genetics also manifests itself through the generation: with completely clean skin from parents, grandchildren inherit moles from grandparents.

Experienced doctors identify several main causes of moles :

• ultraviolet exposure and periods of increased solar activity
• frequent skin injuries and superficial injuries
• elevated radioactive background
• non-compliance with the principles of healthy eating and lifestyle , the presence of bad habits and addictions
• disturbed hormonal background
• hereditary tendency to neoplasms

The appearance of dangerous moles with single injuries is not at all necessary, and the slightest hormonal failure is not yet a reason for panic.

Caution is not superfluous where several risk factors act at once. It is always important to take a reasonable approach to your own health: if a person takes sunbaths, then he definitely does not need a solarium, and a balanced diet and quitting smoking definitely benefit both the skin and the whole body.

Types of moles

Moles are skin growths. They consist of epithelial and pigment cells, which are always present in humans. Not all formations on the skin are the same: there are the usual benign moles, birthmarks that do not threaten anyone, but there are also potentially dangerous ones. They need to be able to distinguish.

Epidermal

The most common formations of epidermal origin. They are in the top layer of the skin. These types of moles are different from each other. Among them there are non-specific species:

• Borderline nevus. Such a mole may be congenital in origin, but sometimes it gradually forms throughout a person’s life. It can be seen if you carefully examine the palms, feet, lower abdomen. In appearance, this is a small speck or seal with uniform coloring. The color varies from any shades of brown to blue-black. The size also varies from a few millimeters to 1-2 cm.
• Intradermal nevus. This mole is more common than others. They look like a convex area of ​​​​the skin, protruding slightly above its surface. You can find it anywhere on the body. A rounded formation in diameter reaches 1 cm, the color is brown or black. In case of accidental injury, it bleeds easily, shrinks in size.
• Complex nevus. The congenital form of moles has transitional features. This variety is somewhat similar to others, but can combine different features. There are spots and seals on the mole, but it is not possible to notice the favorite location.

Specific types include:

• Epithelioid nevus. A benign mole may be present as a single formation or located in groups, most often on the legs and face. She is easily injured. Its dimensions do not exceed 2 cm. The peculiarity of such a mole is the ability to spontaneously disappear.
• Nevus of balloon cells . Occurs infrequently. The spot or seal on the skin becomes brown in color with a characteristic yellow ring along the edge of the formation.
• Nevus Setton . Single or multiple moles are benign formations with discolored areas of the skin around. Typically, the appearance of such nevi in ​​people with vitiligo or with concomitant autoimmune diseases. May undergo reverse development, gradually resolve.

Dermal

Benign formations are formed in the deep layers of the skin:

• Mongolian spots . Moles of rather large sizes reach 6-10 cm, they are already found in newborns in the region of the sacrum, gluteal folds, and on the hips. They differ in constancy, do not undergo changes during life and are often inherited.
• Nevi Ota-Sato . Pigmented formations on the skin look like a group of adjacent spots. They attract attention with dark blue staining on open areas of the body – under the eyes, around the nose, on the cheeks. Similar inclusions are described on the mucous membrane of the nasal cavity, mouth, and iris.
• Nevi Ito . In appearance, the spots are practically no different from the previous variety. A different location of moles is characteristic – on the neck, in the scapular region, above the collarbones. They do not go away with age, they are more common in representatives of the Mongoloid and Negroid races.
• Blue nevi. Dense nodules from 1 to 3 cm in size become gray or black over time. Appear on the skin of the scalp, the back surface of the feet and hands, above the sacrum.

Mixed

Such moles combine the signs of nevi of various localization and origin. Usually these are congenital formations with a clear or blurry contour. Their sizes vary greatly and sometimes do not exceed 1 cm, but in some cases they reach gigantic sizes, occupying almost the entire visible surface of the skin on the face, neck, and torso. Such nevi are not capable of spontaneous resorption.

The most dangerous for cancerous degeneration are moles, formed mainly from melanocytes. They often give rise to malignant tumors. At the initial stages of their development, dangerous moles have a brownish, reddish or reddish hue. The primary focus of the disease occupies at least 0.5 cm. Rarely located on visible and easily accessible areas of the skin, they are found upon careful examination on the back, in skin folds.

Mole-like lesions

A common feature in all moles is the presence of cells with melanin pigment. In the people, moles are more often called any skin neoplasms:

• The closest “relatives” of moles are benign warts or spines . These are growths on the skin associated with infection. They owe their appearance to the human papillomavirus (HPV). You can get infected with the virus through everyday life. The disease easily penetrates into the children’s body, because. the skin of a child is thin and prone to frequent microtrauma.

Spines are rounded plaques with a compacted base and a dark dot in the center. They occur on the hands and feet, single formations are rare. Warts quickly increase in number and size, can cause intense pain in the legs when squeezed by shoes.

• Papillomas (pedunculated moles) are also associated with skin penetration of HPV. Their main difference is the presence of a thin “leg” no more than 1-2 mm in diameter and a slightly larger nodule. They can be smooth or rough to the touch, sometimes reminiscent of cauliflower in appearance. Such formations usually do not pose a health hazard, they are located in various parts of the body or on the face.
• Keratomas are also called senile warts. Their number increases with age. Dense plaques can increase in diameter, separate into separate fragments, become covered with scales and even crumble. Keratomas can be distinguished from other neoplasms by a cracked gray or brownish surface.
• Atheromas (wen) – a consequence of blockage of the excretory ducts of the skin sebaceous glands. Outwardly, these smooth flesh-colored formations can be distinguished by their hemispherical shape. They increase very slowly – 2-3 mm per year, prone to the development of inflammation. In such cases, they become very painful and are removed surgically.
• Hemangiomas – red moles, in the form of spots or raised soft nodules, are often present on the skin of infants. They are areas of abnormally developed vessels, often injured and at the same time bleed heavily. As the child grows, hemangiomas also increase, sometimes reaching impressive sizes.

To understand the intricacies of the structure of each type of moles can dermatologist. At the first suspicious signs of unusual “behavior” of moles, you need to consult a specialist and make sure that there is no danger to health.

When to see a doctor

With all the variety of moles, there are those that require close attention. Most often they have to be removed. If left as is, the consequences can be very unpleasant and often unpredictable. That is why any pigmentation on the skin is alarming.

An urgent consultation with a dermatologist is needed in the following situations:

• long-term dermal formation changes shape , loses its symmetry and increases in one direction
• former borders change – edges become torn, lose even contours
• the color of the mole also changes, its surface becomes uneven in color with spots and patches of various shades
• dimensions increase noticeably in a short period of time
• smooth apex becomes rough or even bumpy, while previously rough looks smooth
• hairs suddenly fall out from the surface of pigmented skin
• mole begins to peel off , new sensations appear – itching, soreness or burning

The 3 most commonly detected skin cancers

Why is it so urgent to deal with moles that have been present on the skin for many years? The thing is that with the unusual “behavior” of moles, their malignant degeneration is very likely.

Basalioma (basal cell carcinoma)

The tumor begins its development at the age of 40-50 in the superficial layers of the skin. At the very beginning of the disease, it is almost invisible, it looks like a small pimple. It is usually seen on the face or neck. In closed areas of the body, patients simply do not pay attention to it.

A dense pinkish or flesh-colored nodule with a smooth surface and a depression in the center is often covered with a crust. After an accidental removal, it soon reappears, and then begins to bleed a little. At this stage, it is still easy to get rid of the disease. The main thing is to understand in time that we are not talking about a pimple at all, but about a serious tumor.

If timely diagnosis is not carried out, the tumor almost does not change for several years and almost does not manifest itself. After a cut, burn, or exposure to any chemicals, it begins to grow sharply, can affect the muscles, cartilage and periosteum, and cause severe pain. It is very difficult to cure cancer at this stage.

Melanoma

The most malignant cancer of all known types of cancer. In the zone of increased risk are fair-skinned adults with a burdened heredity, as well as patients who suffered significant sunburn in childhood.

A frequent source of tumor development is the pigment cells of moles. In visible areas of the skin, a person notices unusual changes in the usual nevi – uneven edges, asymmetric shapes, uneven coloring, a rapid increase in diameter.

More recently, the diagnosis of melanoma meant an extremely unfavorable prognosis. Now the situation has changed. Scientists have developed highly effective methods of tumor immunotherapy, but they have not reduced the severity of the disease. Any atypical formations on the skin deserve close attention.

Squamous cell carcinoma

One in five cases of skin cancer is associated with this aggressive malignancy. It often appears in the elderly, but the development of the tumor is possible at a younger age. It develops in open areas of the body against the background of precancerous diseases – chronic inflammatory processes, trophic ulcers, benign moles.

Researchers point to the association of this type of cancer with certain strains of HPV, excessive sunburn, occupational exposure to carcinogens, and immune defects. Suspicion of cancer arises in the presence of an ulcer of an indefinite shape. It is surrounded by a dense roller and sometimes covered with a massive dark crust.

The insidiousness of the disease lies in the rapid deep growth of the tumor. A small formation on the outside quickly penetrates into all layers of the skin, soft and hard tissues, and actively metastasizes. Initial forms of cancer are amenable to successful treatment, but early diagnosis of the tumor is often delayed.

How do we determine whether we have a mole or cancer

Timely examination by a specialist helps to resolve all doubts.

Visual inspection

At the first appointment, the doctor detects signs of the disease. In favor of the benign nature of the mole, they say:

• Fixed dimensions . A slight increase is observed only in adolescence and at a young age (up to 30 years).
• Uniform staining . Pigment cells are distributed over the entire surface of the mole.
• Edge sharpness . In real birthmarks, clusters of pigment cells are observed only within existing formations.
• Symmetry . If you mentally draw a line through the middle of the nevus, both parts of it are approximately the same.

Dermatoscopy

Dermatologists use a dermatoscope to diagnose tumors. Even a tenfold increase allows you to notice important features of the neoplasm that are not visible to the ordinary eye. Video dermatoscopes increase the image by more than 1000 times. Digital devices are able to additionally record and process the information received.

The procedure is bloodless and painless. With its help, the doctor detects changes inherent only in cancerous tumors. An accurate diagnosis can be made already at the initial stage.

Additional methods

The doctor confirms the dermoscopic signs of cancer with a biopsy and histological examination. Under local anesthesia, a piece of suspicious tissue is removed and sent to the laboratory. Further actions of the doctor and the patient depend on the results obtained.

Do moles need to be removed

While scientists were studying the features of benign and malignant human tumors, the most radical methods of treatment were proposed and applied. One of them was the global removal of all moles on the skin. The passion for this method of preventing cancer did not bring anything good: it turned out that even complete surgical cleansing of the skin from moles does not affect the incidence of melanoma in any way.

Over time, another extreme emerged. They stopped getting rid of moles, because. decided that it was the removal that causes the malignant process. This decision also turned out to be wrong: cases of skin cancer have become more frequent.

Modern doctors have found a golden mean in resolving the issue of the need for surgery.

Through the dermatoscope, the so-called dropout zone is visible. It includes tiny formations around the mole, similar to its structure and appearance. The presence of such clusters of cells indicates that the mole is growing and spreading to neighboring areas. With a high probability, it will soon turn into a dangerous tumor, so the mole must be removed.

Assessment according to the ACKORD system

External examination of the skin takes into account the so-called alphabet of melanoma ABCDE (corresponds to the Russian abbreviation ACCORD). According to this system, dermatologists agreed to determine the degree of goodness of various skin neoplasms.

Uniform approaches to diagnostics simplify the decision to operate. The following criteria are taken into account:

• A – asymmetry in the appearance of a mole
• K – edges (flat or not)
• K – bleeding + crust on the surface of the mass
• O – color (uniform or with inclusions of different shades)
• P – sizes (increase over time or do not change)
• D – dynamics (signs change over time).

If most of the ratings indicate dangerous symptoms, the doctor recommends removing the mole.

Mapping

The procedure is needed for patients with multiple moles on the body. Every year, the doctor examines the patient with a dermatoscope. The assessment results are recorded in a special card. Process dynamics are taken into account. The question in favor of surgical treatment is decided when the assessment according to the ACCORD system worsens.

Findings

Skin lesions are completely different. Harmless-looking moles are not always benign, and any newly appeared small tumor does not necessarily turn out to be cancerous.

The risk of malignant degeneration is always present for any mole, but is not necessarily realized. Timely diagnosis of cancer requires careful attention to skin neoplasms, observation of any changes in their “appearance” and “behavior”. If they are present on the skin, you need to visit a dermatologist at least once a year and undergo a dermatoscopy procedure.