Malignant Skin Lesions:
Types of Skin Cancer

BCC (Basal cell carcinoma)


What is it?

Basal cell carcinoma is the most common and easiest-to-treat skin cancer. Because basal cell carcinoma spreads slowly, it occurs mostly in adults. It accounts for 60% of all types of skin cancers in Australia.

BCCs are usually painless and typically grow slowly over months or years. BCC may not be noticed or it may be a persistent change to an area of skin that is red, itchy, pimple like or scar like. Changes occur over months and the BCC will flare up and heal and may also bleed intermittently or ulcerate.

They rarely spread to other parts of the body. Almost half of the BCCs appear on the head and neck in people of fair skin over the age of 40.

Sun exposure may not be the only causative factor of BCC because BCCs may appear in skin that has not been exposed to the sun.

What does it look like?

There are many varieties of BCCs and each can look different on the skin.

BCC may appear as a pearly white or waxy bump, often with visible blood vessels, on the ears, neck, or face.

BCC may also appear as a flat, scaly, flesh-colored or pink patch on the back or chest, or more rarely, a white, waxy scar.

What is the treatment?

The earlier a BCC is diagnosed the easier it is to treat. If left untreated it can grow deeper into the skin and damage nearby tissue making treatment more difficult.

  • Surgical: Surgical excision is the treatment of choice for many BCCs
  • Non surgical: Aldara; PDT; cryotherapy
What about the future?

Having one BCC increases the risk of getting another. It is possible to have more than one BCC at the same time on different parts of the body. There is a small risk of recurrence of BCC after it has been treated. You may develop another BCC or another types of skin cancer.

A yearly full skin check is advisable.

SCC


What is it?

Scc is the second most common form of skin cancer accounting of about 30% of all skin cancers in Australia.

SCCs usually develop in areas that have been damaged by sun exposure. They are commonly found on the face, ears, lower lips, forehead and balding scalp, arms, back of hands and lower legs.

SCC is more common as you get older because the most common cause of SCC is cumulative, long term exposure to UV light form the sun over your lifetime.

SCCs tend to grow quickly over several weeks or months. SCCs may spread to other parts of the body if left untreated. SCC on the lips and ears is more likely to spread and should be examined by as doctor as soon as possible.

What does it look like?

SCCs often look like scaly red patch, a crusted spot or a rapidly growing lump. They may crust or bleed, become inflamed and may be tender to touch. The skin where SCC develop often has telltale signs of sun damage including

What is the treatment?

SCC is curable if treated early. If SCC becomes advanced, treatment will depend on the stage.

Cutaneous horn


Cutaneous horn appears as a crusty growth that extends from a red base on the skin. It usually occurs in elderly adults with a past history of sun exposure.

It is composed of compacted keratin (scale) and is a specialisedtype of actinic keratosis.

The size and shape of the growth varies and it projects a few millimetres above the skin.

Squamous cell carcinoma can be found at the base.

Bowen disease (SCC in situ)


Bowen disease is also called squamous cell carcinoma "in situ."

It is a type of SCC that spreads on the surface of the skin.

By contrast, SCC is often referred to a “invasive” rather than “in situ” because it grows inwards more than on the surface of the skin and spread to other parts of the body.

Bowen disease looks like scaly, reddish patches that may be crusted.

It may be mistaken for a rash, eczema, fungus, or psoriasis.

KA (keratoacanthoma)


KA is a skin lump that is volcano shapedwith a distinct crater at the top of the lump that has keratin inside.

It usually grows quickly on the skin. KA appears on skin that’s been exposed to the sun, like your head, neck, arms, the backs of your hands, and sometimes your legs.

It is not unusual for a single KA to shrink and disappear on its own after several months. But it may leave a worse scar than one from surgery. It could also come back, so it’s best to get it removed. If you don’t treat it, a KA can spread throughout your body.

The most common treatment is surgery to remove the keratoacanthoma.

Melanoma


What is it?

Australia has the highest rates of melanoma in the world. Melanoma is the third most common cancer in both men and women. One in 13 men and one in 22 women will be diagnosed with melanoma before age 85.

Melanoma is one of the least common skin cancers and is considered the most serious type of skin cancer because it is more likely to spread to other parts of the body, especially if not detected early. Melanoma is not that hard to find and the earlier melanoma is found, the more successful treatment is likely to be.

Melanoma grows faster than other types of skin cancer, and it can spread beyond your skin to other parts of the body, including your bones and brain. Then it's very hard to treat and can't be cured.

What does it look like?

There are different types of melanoma and melanoma can vary greatly in the way it looks.

In people who have lots of moles, melanoma usually stands out and looks different from the other moles. The first sign is often a new spot or a change in an existing mole.

  • Size – The spot may appear or grow larger.
  • Colour – The mole may become increasingly blotchy with different depth and shades of colour (brown, black, blue, red, white, light grey, pink or skin-coloured).
  • Shape or border – The spot may increase in height, become scaly, have an irregular edge (scalloped or notched) or lack symmetry (the halves look different).
  • Itching or bleeding – The mole may itch or bleed at times.
  • Elevation – the spot may start as a raised nodule or develop a raised area, which are often reddish or reddish brown.

New moles can appear during childhood and through to the 30s and 40s, as well as during pregnancy. However, adults should see their doctor to get a new mole examined, particularly if it is noticeably different from other moles or is raised, firm and growing. Even if you have had a mole checked before and it was considered benign, it is important to regularly check your skin for any change in shape, size or colour in the future. Talk to your doctor immediately about any changes.

Uncommon skin cancers


Uncommon types of skin cancer include:

  • Merkel cell carcinoma, which is usually found on sun exposed areas on the head and neck. It often grows quickly and spreads to other parts of the body.
  • Sebaceous gland carcinoma, an aggressive cancer originating in the oil glands in the skin.