DIAGNOSIS & TREATMENT Skin Cancer

What is Skin Cancer?

Facts & Figures

Skin cancer is the most common type of cancer, more common than all other cancers combined. At least 1 in 5 people will get a skin cancer sometime during his or her life. When detected and treated early, most types of skin cancer have very high cure rates.

All of the providers at Moy-Fincher-Chipps are skin cancer experts. We specialize in skin cancer prevention, early detection, and highest cure-rate treatments. Dr. Ronald Moy, Dr. Edgar Fincher, Dr. Lisa Chipps, and Dr. Jennifer Herrmann are all board certified, fellowship-trained Mohs Micrographic skin cancer surgeons.

Types of Skin Cancer

Basal cell carcinoma (BCC)

BCC is the most common type of skin cancer. It often presents as a pimple that doesn’t go away but may look like a rough pink-red spot or flesh colored skin growth. BCCs derive from cells located within the basal layer of the skin and grow in various patterns. Although some patterns tend to behave more aggressively than others, BCCs typically grow slowly and do not spread to other parts of the body. However, BCCs do not resolve on their own and should be treated.

Squamous cell carcinoma (SCC)

SCC is a common type of skin cancer that derives from squamous-type skin cells. SCCs may look like a scaly red spot or sore that does not heal. These cancers may grow more quickly than BCCs and can spread to lymph nodes in some circumstances. Spread is more likely in patients that are immunosuppressed or if tumors have aggressive features under the microscope.

Malignant melanoma in situ (MMis)

MMis is a type of skin cancer that derives from melanocytes, also known as the pigment cells of the skin. They are therefore most often brownish in color. In situ mean “in place,” and this place is the epidermis or the very lop layer of the skin. Since the epidermis has no blood vessels or lymph glands, MMis located in this layer cannot spread to lymph nodes or other organs. Because of this, when MMis tumors are treated appropriately, they have very high cure rates. On the other hand, if these initially shallow tumors are allowed to grow without treatment, they may expand and send roots into deeper layers of the skin or beyond.

Malignant melanoma (MM)

Invasive MM is often considered the most dangerous type of skin cancer. It typically looks like an unusual mole that is asymmetric, has irregular borders or multiple colors, and is larger than a pencil tip eraser. Although sun exposure is a risk factor, genetics also play a role. If one of your immediate family members has had a MM, your chance of getting one is higher than someone who has no family history of this diagnosis. If detected early, MM is most often curable through minor surgery. However, if this tumor has grown more deeply in the skin and has spreads to lymph nodes or other organs, cure rates are low.

Rare skin cancers

There are many additional rare forms of skin cancer, such as merkel cell carcinoma, sebacceous carcinoma, adnexal carcinoma, eccrine or apocrine carcinoma, dermatofibrosarcoma protuberans (DFSP), atypical xanthoma, undifferentiated pleomorphic sarcoma, leiomyosarcoma, skin T-cell or B-cell lymphomas, and others. All of our surgeons are trained in treating complex and rare skin tumor. Treatment will vary depending on the exact cancer type, its location on your body, and its aggressiveness. We will help formulate the most appropriate, best evidence-based treatment plan for you specifically. Sometimes this involves the use of medications, surgery, or coordination of care with other local cancer physicians.

What is a dysplastic nevus?

A dysplastic nevus is a type of mole that looks unusual or atypical. Common or “typical” moles have round borders, are symmetric, uniform in color, and less than ¼ of an inch wide. Atypical moles may be several colors, from pink to brown to very dark brown. They may have irregular, asymmetric borders and are sometimes larger than ¼ of an inch wide. Dysplastic nevi may occur anywhere on the body but are most often found on skin that has had significant sun exposure.

Under the microscope, dysplastic nevi have disorganized architecture that ranges from mild to severe. Those that have more severe disorder have a small chance of turning into a melanoma skin cancer. For this reason, severely dysplastic nevi are most often removed. Having many dysplastic nevi, >10, is also a risk factor for melanoma. If you or an immediately family member has many dysplastic nevi, it is important that your dermatologist regularly examines all of your skin fully.

What is a pre-skin cancer?

A pre-skin cancer is also known as an actinic or solar keratosis. They typically present as rough red spots that are easier to feel than see. Longstanding sun exposure is the biggest risk factor for the development of these pre-skin cancers. They are most often found on the face, ears, scalp, arms, and hands. Sometimes they are asymptomatic but occasionally they sting. Although pre-skin cancers may come and go, a small percentage of them go on to become skin cancers. For this reason, they are often treated with liquid nitrogen or topical medications, such as Efudex (5-fluorouracil) or Aldara (imiquimod). Both of these medications selectively destroy pre-skin cancer cells while sparing surrounding normal cells.

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