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Skin Cancer Malignant Melanoma Melanoma is a potentially deadly form of skin cancer that arises from the pigmented cells, or melanocytes of the skin. It seems to occur more often in people who have had many sunburns. In the US, about 1 in every 100 people will develop melanoma. Those at higher risk have red or blond hair, fair skin, blue eyes, or a family history of melanoma. The best way to identify suspected melanomas is to look at your skin. There are four ways to identify melanomas. 1. Asymmetry:  Neither side matches the other. The left side is unlike the right. 2. Irregular border:  There is no defined border. Edges are blurred or ragged. 3. Variation of Color: The color is not uniform. There could be red, blue, black, tan, brown or other colors within the mole. 4. Size or Diameter:  A melanoma is usually larger than 6 millimeters in diameter. This is about the size of a pencil eraser. If you have any of these symptoms, please contact a doctor immediately. Early treatment is essential. Dr. Perniciaro is an expert in dealing with this disease and other types of skin cancer. Basal Cell Carcinoma Basal Cell Carcinoma usually first appears as a small red bump or nodule on the neck, head or hands, but can occasionally occur as red patches on the chest and back. These nodules, if left untreated will bleed, crust over and heal, then repeat the cycle. These cancerous cells most often appear on fair-skinned people with light eyes. African Americans are seldom affected with this cancer. This cancer grows very slow and does not usually spread to other parts of the body, however if left untreated can cause severe local damage to skin and bones. Squamous Cell Carcinoma This type of skin cancer is typically located on the mouth, lips, face and around the rim of the ears. It often appears as a red scaly patch or bump and will turn into a large mass if left untreated. Unlike basal cell carcinoma,squamous cell carcinoma will spread to other parts of the body. However, both of these cancers have a 95 percent cure rate when treated early with dermatologic surgery. Sun Damage Precancerous Actinic Keratosis Precancerous Actinic Keratosis is often the first phase in developing skin cancer. These precancerous areas usually start as a scaly or crusty bump on the skin surface. This precancer is most likely to appear on the lips, mouth, ears, bald scalp, neck, back of hands or forearms. Older patients are more succeptable because this type of precancer is a result of cummulative sun exposure and damage. African Americans do not often have this type of cancer, however fair-skinned individuals have a much greater chance of contracting these precancerous areas. There are many treatments for Actinic Keratosis if caught early in development. Not all these lesions need to be removed, but it is a good idea to contact your dermatologist to seek a proper treatment course if you find any of these areas on your skin. Treatment Options Cuttettage and Electrodesiccation This is the most common method of treating precancerous lesions. The dermatologist scrapes the lesion and controls bleeding by heat produced by an electric needle. A biopsy is then sent to check for malignancy. Shave Removal This treatment uses a scalpel to shave the keratosis and obtain specimen for biopsy. Bleeding is controlled by cauterization. Cryosurgery This treatment freezes off lesions with liquid nitrogen. It requires no anesthesia and produces no bleeding. Dermabrasion This treatment removes the upper layers of skin with a fine wire brush or by sanding the area. Redness and some soreness last for several days following the procedure. Chemical Peel For this treatment the dermatologist spreads an application of phenol or tricholoacetic acid to the affected area. This causes the top layers of skin to slough off and be replaced by new skin within seven to ten days. Topical Medications There are two medications which applied twice daily for four to six weeks will effectively remove precancerous areas. Check with Dr. Perniciaro or Dr. Boyd for more information about these creams. Mohs' Micrographic Surgery for Skin Cancer This treatment is an outpatient treatment performed in either of our local offices. This treatment is a modification of chemosurgery originated by Dr. Mohs in the 1940's. The procedure is designed to save as much of the healthy tissue as possible while removing all of the tumor. Mohs' Micrographic Surgery requires only local anethesia. First, the tumor is removed and the wound is dressed. Patients are then asked to wait in the office while the tissue is checked for cancer at the margins. When the dermatologist is sure that all the cancer has been removed, the wound is stitched up and the pateint is sent home. Patients who have one instance of skin cancer will often develop another instance during their lifetime. It is most important to keep checking the skin for new areas and always where at least a sun screen of at least SPF 15 or higher when exposed to the sun.