Types of Skin Cancers

Basal cell carcinoma (BCC)

BCC is the most common type of skin cancer.  It often presents as a pimple that doesn’t go away.  Other times it 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. Unfortunately, BCCs do not resolve on their own and need to 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 a wound 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 (MIS)

MIS is a type of skin cancer that derives from melanocytes, also known as the pigment making cells of the skin.  They are most often brown in color.  In situ mean “in place,” and in this case is located in the epidermis or the very top layer of the skin. MIS located in this top layer do not spread to lymph nodes or other organs.  Therefore, when MIS tumors are treated appropriately, they have very high cure rates.  On the other hand, if these shallow tumors are allowed to continue grow without treatment, they can expand and send roots into deeper layers of the skin or beyond and do have the potential to spread to other areas.

Malignant melanoma (MM)

Invasive MM is 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 can be 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 not as promising.

Rare skin cancers

There are many additional rare forms of skin cancer, such as Merkel Cell Carcinoma, Sebaceous carcinoma, Adnexal carcinoma, Eccrine or Apocrine carcinoma, Dermatofibrosarcoma protuberans (DFSP), leiomyosarcoma, Kaposi sarcoma, skin T-cell or B-cell lymphomas, and others.   Treatment will vary depending on the exact cancer type, its location on your body, and its aggressiveness.  We will help plan for the most appropriate, best evidence-based treatment plan for you.  Sometimes this involves the use of medications, surgery, or coordination of care with other local cancer doctors.

It is recommended to get a full body skin check annually to catch any skin cancers early.  Large swaths of our body are rarely seen by us such as our back and need to be monitored for potential skin cancer.  If you see anything changing over time, it’s quite possibly a skin cancer that needs treatment.

What is a pre-skin cancer?

A pre-skin cancer is also known as an actinic keratosis 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-cancers.  They are most often found on the face, ears, scalp, arms, and hands.  Sometimes they are asymptomatic but occasionally they sting.  Although pre-cancers may come and go, about 1% of them go on to turn into 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 topical prescription medications selectively destroy pre-skin cancer cells while sparing surrounding normal cells.

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 have 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 moles have chaotic architecture that range from mild to severe. Those that have more severe structures 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 your skin.