Detect Spot the Spot

Spot The Spot

1Actinic Keratoses (AK)

How do you spot it?
  • AK is characterized by rough, scaly papules, plaques or nodules with a skin-coloured, reddish or reddish-brown appearance
  • 1-2 mm to several cm in size
  • In patients with darker skin, AK can be pigmented
  • Rough surface, easily felt on palpation
  • The clinically visible lesion does not reflect the “real” extent of histological damage
  • AK present in photo-damaged skin
Clinical signs that should “alert” us
  • Induration
  • Rapid growth or failure to respond to other treatment modalities
  • Recurrence or persistence
  • Bleeding
  • Pain
  • Thickening
  • Inflammation
Where does it normally occur?
  • Most commonly found on sun-exposed areas such as the scalp, face, neck, arms and hands
  • Fair skinned people who have light-coloured hair and eyes stand at a higher risk of developing AK
  • People who are immunosuppressed or have an immune deficiency are also at a higher risk of developing AK
  • AK occurs more commonly among older adults and seniors
How does AK progress?
  • This premalignant condition appears as a thick Actinic Keratosis – also known as solar keratosis and senile keratosis – appears as a thick, scaly patches of skin
  • AK has a 5-10% potential to become skin cancer such as squamous cell carcinomas, basal cell carcinoma and malignant melanoma
  • AK may lead to melanoma and patients that develop AK are more prone to also develop melanomas through overexposure to the sun
  • About 10 to 20% of patients with multiple AK lesions will probably develop SCC/Squamous Cell Carcinoma during the following ten years
  • 65% of SCCs arise from clinically diagnosed AK
Will AK recur?
  • The lesions could recur over time
Field Cancerization
  • UV-exposure damages widespread areas of the epidermis causing molecular changes, but remaining clinically and histologically normal for a prolonged period
  • Normal-appearing skin surrounding AKs frequently expresses molecular changes and the whole area has the potential to develop AK. This is called “field cancerization”
  • AK is thus a chronic condition in which new or recurrent lesions continue to develop over time on a background of sub-clinical disease
  • Sub-clinical (non-visible/non palpable) AKs are estimated to occur up to 10 times more often than visible AKs, particularly in sun-damaged skin
Treatment
  • There are a number of ways to cure or remove AK, including topical creams which can be highly effective. Consult your doctor and remember to ask him about the cream treatment for Actinic Keratosis!

2Basal Cell Carcinoma (BCC)

How do you spot it?
  • BCC typically presents as a small pearly or crusty patch that fails to heal.
  • Painless and often take months to years to be shown to a doctor.
  • Easily identifiable by the blood vessels which are prominent in the bump.
  • Over time, bleeding and crusting ulcers are the reason most people will seek medical advice.
Where does it normally occur?
  • most often identified on the face
  • 70% of BCC diagnosed on the lips, cheeks, ears, nose, and scalp.
  • Also commonly diagnosed on back of the neck, shoulders, forearms, hands, back, lower legs
How does BCC progress?
  • lesions are slow-growing and rarely develop the ability to spread to lymphatic systems or other parts of the body
  • Can progress locally and ruin nearby structures which can disfigure a person
  • These lesions are often neglected because of their slow growth
  • Left untreated for too long and it may invade adjacent areas, including blood vessels, cartilage, and bone
Will BCC recur?
  • Risk factors for the recurrence of BCC include depth of invasion, pathologic sub-type, and perineural invasion ( spreading to the space surrounding a nerve )

3Squamos Cell Carcinoma ( SCC )

How do you spot it?
  • SCC is a malignant skin tumour, which arises in the epidermis and is typically a small, painless, elevated and crusty lump. They typically occur in areas of hyperkeratosis (thickening of the outer skin layer) and approximately 65% arise from actinic keratosis – a precancerous dry, scaly lesion, typically located in areas of significant sun damage
Where does it normally occur?
  • The most common location of squamous cell carcinomas is the face. Other areas at high risk include the back, shoulders, forearms and hands, lower legs
How does SCC progress?
  • As the lesions grow, they can become an ulceration and may bleed. SCCs tend to develop more rapidly than BCCs, and unlike BCC, SCC can spread to the local lymphatic system
Will SCC recur?
  • Risk factors for recurrence after treatment of squamous cell carcinomas include perineural invasion, tumour thickness, and poorly differentiated histology

4 Non-melanoma Skin Cancer

What are the types of non-melanoma skin cancer?

There are three primary types of skin cancers, such as:

  • Basal Cell Carcinoma (BCC)
  • Squamous Cell Carcinoma (SCC)
  • Melanoma

In fact, BCC accounts for 65% of all skin cancers, SCC accounts for 35%, and melanoma accounts for 1.5%.