In the epidermis, the outermost layer of skin, skin cancer is the uncontrollably growing abnormal cells that result from unrepaired DNA damage that causes mutations. It happens when damage from ultraviolet (UV) light from the sun or tanning beds causes skin cells to proliferate out of control.
Types of Skin Cancer
Basal Cell Carcinoma (BCC)
- The most prevalent and least hazardous kind.
- Originates from basal cells, which are located in the epidermis’ lowest layer.
- Frequently manifests as an elevated, painless patch of skin that may be glossy and covered with tiny blood vessels, or it may look like an unhealing sore.
Squamous Cell Carcinoma (SCC)
- The second most typical kind.
- Originates in the squamous cells that are present in the skin’s outer and middle layers.
- Commonly appears as a raised, red, scaly, or crusty patch that is generally found on sun-exposed areas such as the back of the hands, ears, lips, and face.
Melanoma
- The rarest, yet most hazardous kind.
- Arises from melanocytes, which are the cells that generate the pigment known as melanin, which gives skin its colour.
- May manifest as a brand-new mole or as an already-existing mole that changes in hue, size, or form.
- Frequently distinguished by a diameter larger than 6 mm, asymmetrical shape, uneven borders, various colours, and evolution or change over time (the “ABCDE” rule).
Risk Factors.
DNA damage in skin cells is one of the main causes of skin cancer, as it can lead to aberrant cell proliferation and tumour formation. The primary reasons and explanatory elements are as follows:
Radiation in the Ultraviolet (UV)
- Sun Exposure: Sun exposure, specifically UV radiation from the sun, is the primary cause of skin cancer. UV radiation can cause DNA damage to skin cells, which can result in mutations and the growth of cancer.
- Tanning Beds: Sunlamps and other artificial UV radiation sources, like tanning beds, also raise the risk of skin cancer. Concentrated UV radiation from these gadgets has the potential to be even more dangerous than sunshine.
Genetic Elements
- Family History: A genetic susceptibility to skin cancer is indicated by a family history of the disease, which raises the risk.
- Conditions That Are Inherited: Skin damage from UV radiation is mostly prevented by the skin when certain genetic abnormalities, such as xeroderma pigmentosum, are present. This greatly raises the risk of developing skin cancer.
Type of Skin
- Fair Skin: Melanin, the pigment that offers some protection from UV rays, is less prevalent in people with fair skin, light-colored eyes, and blond or red hair. This increases their vulnerability to UV-induced DNA damage.
Immune System Weakness
- Immunosuppression: Those with compromised immune systems, such as those on immunosuppressive medication after receiving an organ transplant or those living with HIV/AIDS, are more susceptible to skin cancer. A compromised immune system is less capable of recognising and eliminating malignant cells since the immune system is involved in this process.
Exposure to Chemicals
- Chemicals that Cause Cancer: The risk of skin cancer can be raised by exposure to specific chemicals, including arsenic, coal, industrial tar, and some types of oil.
Persistent Skin Injury and Inflammation
- Prolonged Inflammation: The risk of skin cancer might be raised by chronic inflammation or skin damage, such as burns or scars.
- Radiation Exposure: Having received radiation therapy for another ailment in the past may make you more susceptible to skin cancer.
Older Age
- Age: As UV exposure accumulates over time and can cause cancer, the chance of developing skin cancer rises with age.
Prior Skin Cancer
- History of Skin Cancer: People who have had skin cancer in the past are more likely to have it again.
Atypical Moles
- Atypical (Dysplastic) Moles: Atypical moles, or a high number of moles, raise the risk of melanoma, a serious kind of skin cancer.
Treatment of Skin Cancer
The kind, size, location, and stage of skin cancer, together with the patient’s general health, all influence the course of treatment. Typical therapies consist of:
Surgical Interventions
- Excisional Surgery: Excisional surgery involves removing the malignant tissue while leaving a margin of healthy skin intact.
- Mohs Surgery: A meticulous surgical method that eliminates cancer layer by layer while thoroughly inspecting every layer under a microscope until no malignant cells are left. Often used in areas that are sensitive to appearance for BCC and SCC.
- Curettage and Electrodessication: Removing the cancerous cells and utilising electric currents to destroy any cancer cells that may still be present.
Non-Surgical Interventions
- Cryotherapy: Using liquid nitrogen to freeze cancer cells is known as cryotherapy. Often for tiny, early-stage malignancies and precancerous tumours.
- Radiation Therapy: When surgery is not an option, radiation therapy is often used to target and kill cancer cells using high-energy rays.
- Topical Treatments: Topical treatments involve putting ointments or creams directly on the skin. These may consist of chemotherapy (such as 5-fluorouracil) or immunotherapy (such as imiquimod).
Innovative Melanoma Treatments
- Immunotherapy: Medication (e.g., pembrolizumab, nivolumab) that stimulates the immune system to identify and eliminate cancer cells.
- Targeted Therapy: Pharmaceuticals known as “targeted therapy”—such as BRAF inhibitors like vemurafenib—aim to correct particular genetic mutations present in melanoma cells.
- Chemotherapy: Usually used for metastatic or advanced melanoma, chemotherapy is the use of medicines to kill cancer cells.
Photodynamic Therapy (PDT) for Skin Cancers Other Than Melanoma
A method for killing cancer cells that combines light exposure with a photosensitizing chemical.
Monitoring and Follow-Up
- Frequent Examinations: Keeping an eye out for any new or recurring skin malignancies.
- Self-Evaluations: Self-check frequently to identify any new or evolving lesions.
Successful outcomes in the therapy of skin cancer are contingent upon early detection and rapid treatment. It’s critical to get medical advice as soon as possible if you see any unusual changes in your skin.
Conclusion
There are three main forms of skin cancer, which are mainly brought on by UV radiation from tanning beds or the sun: melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC). Melanoma is the rarest but most dangerous type, BCC is the most frequent and least harmful, and SCC is the second most prevalent. Genetic susceptibility, low immunity, chemical exposure, fair skin, and frequent skin injuries are risk factors. Treatment options include non-surgical techniques including cryotherapy, radiation therapy, and topical therapies, as well as surgical techniques like excisional surgery and Mohs surgery. For good results, early detection and treatment are essential. Frequent skin examinations and timely medical consultation in case of questionable changes are crucial.
