What it looks like and where it occurs
Most often, the tumor appears on open areas of the skin. Several appearance options are possible: a dense flesh-colored or reddish nodule, a rough plaque covered with a dense crust or scales, and an ulcer with a raised ridge along the edge, which periodically crusts over and bleeds again. The surrounding skin often shows signs of sun damage - spots, rough areas, deep wrinkles. The tumor grows over weeks and months, not years, and does not go away with ointments and healing agents.
- Dense knot with crust
- Rough plaque that won't peel off
- Non-healing ulcer with a dense edge
- Localization on the face, ears, lip, hands
- Growth over weeks and months
- Bleeding from minor trauma
Causes and precancerous conditions
The main reason is the accumulated dose of ultraviolet radiation over a lifetime, so the disease mainly affects older people with fair skin, who worked outside, as well as tanning salon lovers. The risk is markedly higher in organ transplant patients and anyone taking long-term immune suppressant medications. The tumor can develop at the site of a chronic ulcer, fistula, old burn scar, as well as against the background of precancerous changes - actinic keratosis and Bowen's disease. The human papillomavirus plays a certain role, especially in the genital area.
- Long-term sun exposure and solariums
- Light skin prone to burns
- Actinic keratosis and Bowen's disease
- Immunosuppression after transplantation
- Chronic ulcers, fistulas and scars
- Contact with arsenic and petroleum products
- Human papillomavirus
How is it different from other skin tumors?
Basal cell carcinoma grows slowly over years, looks like a pearly nodule with a vascular pattern, and almost never metastasizes. Melanoma usually develops from a pigmented lesion and is assessed by changes in shape, color and size. Squamous cell carcinoma is often non-pigmented, grows faster than basal cell carcinoma, is prone to ulceration and, unlike it, can spread to the lymph nodes. Separately, there is a keratoacanthoma - a formation that looks very similar to squamous cell carcinoma; it is impossible to distinguish them without histology.
- Basalioma - slow growth, almost no metastases
- Melanoma - change in pigment formation
- Keratoacanthoma - rapid growth, histology required
- Actinic keratosis - rough precancerous lesions
- An accurate diagnosis can only be obtained from tissue examination.
Diagnostics
The doctor examines the entire skin, not just the disturbing area, and evaluates the formation under a dermatoscope - this is a magnifying device with backlight that allows you to see the structure and vascular pattern. Be sure to palpate the nearest groups of lymph nodes. The diagnosis is confirmed only histologically: a biopsy is performed or the formation is immediately removed and the tissue is sent for examination, where the type of tumor, degree of differentiation and depth of germination are determined. For large or recurrent tumors, an additional ultrasound of the lymph nodes and, if necessary, a CT scan are performed.
- Examination of the entire skin and dermatoscopy
- Palpation of regional lymph nodes
- Biopsy with histological examination
- Determination of depth and degree of differentiation
- Ultrasound of regional lymph nodes
- CT scan for suspected spread
Treatment and observation
The main method is surgical removal of the tumor with a supply of healthy tissue and mandatory examination of the edges. For tumors on the face, where it is important to preserve tissue, a method of sequential microscopic control of the edges is used. Radiation therapy is used when surgery is not possible or as an adjunct when there is a high risk of recurrence. Small superficial lesions and precancerous changes are treated with local drugs, cryodestruction or photodynamic therapy. In case of metastases, drug therapy is included. After treatment, regular examinations are necessary: the risk of new skin tumors remains increased.
- Excision with control of resection margins
- Micrographic surgery for facial tumors
- Radiation therapy according to indications
- Local treatment of precancerous lesions
- Removal of affected lymph nodes for metastases
- Dermatologist examinations every 3–12 months
- Lifetime sun protection
