I will tell you about the structure of the skin. It consists of five different layers. The first layer is the epidermis. Below it is a layer of cells that have an awl-like structure. The upper layer of the epidermis (the stratum corneum) consists of Horny plates. Its thickness varies in different places of the human body. It is greatest on the soles and on the palms, and is very thin on the front surface of the neck, under the arms, in the inguinal areas, etc. Keratinization and peeling of the epidermis cells occur very quickly under normal conditions. They are replaced by new cells of the epidermis. Thus, the skin is constantly updated. Under the stratum corneum, there are 4 different layers, of which the most important is the last, the so-called main (basal) layer. The peculiarity of this layer is the presence of thin microscopic slits and spaces between individual cells, through which various liquids and nutrients seep. In the basal layer, cells multiply (divide) very quickly, and pigment is also deposited here. The skin is richly supplied with blood, and the smallest vessels (capillaries) form here the surface capillary plexus. From them, the blood passes into the venous network. The nerves either end freely in the skin, or form specific sensitive nerve devices that lie in close proximity to small blood vessels. The skin has a large number of hair sacs, sweat and sebaceous glands, which are called appendages of the skin. Sweat glands secrete a secret consisting of water, salt, urea, and fatty acids. The sebaceous glands are found in the skin everywhere except in the palms and soles, and the sweat glands are found on both the palms and soles. The sebaceous glands secrete a very important secret for normal functioning – the so-called sebum, which has the form of a liquid oily mass. The doctrine of malignant neoplasms of the skin has been enriched with very important data. They are obtained not only as a result of research on cancer and precancerous skin diseases in humans, but also through numerous experiments on animals (white mice and rats). Those changes that occur in the cells of the human body for 15-20 years, are made in the rat according to the duration of its life for 5-6 months. The described skin diseases necessarily require special treatment, which should begin with the elimination of the cause that caused it. Contact with irritating substances should be completely excluded. Examination by a dermatologist or oncologist is also mandatory in all cases, regardless of whether there was an injury, if the existing skin formation begins to grow, increase in size, ulcerate, bleed, and change its color. You should never attempt to remove all sorts of skin formations yourself-tie their leg with a thread, as some sometimes do, so that the formation becomes dead and disappears, cut it off with a razor, use all sorts of cauterizing agents – copper vitriol, lapis, vinegar essence, etc.Such manipulations, as a rule, do not give the desired result, but, on the contrary, can activate the growth of the existing formation and in some cases even contribute to its malignancy. Malignant skin tumors may develop at the site of scarring and non-healing ulcers – after injury, surgery, burns, inflammatory processes, etc. But not every scar presents such a danger. If the wound healing process is normal, the resulting scar is usually strong and reliable, and if it is not further damaged, then it is not dangerous in the sense of cancer. But sometimes, for one reason or another, the healing of the wound is slow – months, even years. The scar that eventually forms is unreliable and easily vulnerable, especially if it is formed in a part of the body where there is not enough soft tissue and the bone is close (for example, on the front surface of the lower leg). In this case, a very small bruise or some other damage (abrasions with a washcloth when washing, combing, etc.) is enough to form an ulceration on this fragile scar, which then heals extremely slowly and unreliably. Such violations of the integrity of the scar often occur in cases where the scar is located on a part of the body where it is constantly subjected to pressure, pressure, friction, for example, a waist belt, insufficiently spacious or rigid shoes, a shoulder strap (with frequent carrying of a backpack for soldiers, etc.). Frequent trauma is caused by scars located in the area of the joints and restricting movement in them. When a sharp flexion or extension occurs, the scar is torn. Sometimes in the area of scars there are long-term non-healing fistulas, for example, in diseases of the bone, in the presence of foreign bodies in the tissues-fragments after gunshot wounds, etc.the pus Released from the fistula irritates the scar tissue and contributes to its ulceration. Repeated violations of the integrity of the scar and re-emerging in this regard, the recovery processes (regeneration) can create a background on which in the future, most often after many years, can begin malignant growth. Therefore, scars that are often subjected to trauma are subject to surgical treatment – excision, if after this it is possible to bring the edges of healthy tissues together freely enough, without tension, and thus create conditions for rapid healing and the formation of an elastic, soft scar. Burn scars can be a breeding ground for cancer. Repeated, repeated trauma is important in this case. An example is a common form of skin cancer seen among the people of India in the Himalayas. Shepherds of mountain areas for warming the body wear a pot with smoldering coals and hot stones under their clothes, tying it to their stomach. Skin cancer is visible to the naked eye. Therefore, it is easier to study its development than internal cancer. First of all, it was clearly established that, in order to cause precancerous skin diseases in animals, it is sufficient to lubricate their skin, devoid of hair, with carcinogenic substances or expose it to prolonged exposure to sunlight, mainly their ultraviolet part of the spectrum. However, pre-cancer in experimental animals will quickly turn into cancer only with changes in the body. It was found that the transition of skin diseases to cancer is based on metabolic disorders in the entire body, as well as in the area of the skin that is affected by a carcinogenic substance. Senile age, disorders of the endocrine glands, repeated injuries and non-specific irritations, combined with exposure to carcinogens, contribute to the occurrence of malignant skin diseases from pre-cancerous changes that precede them. It should be noted that where the animal’s body and damaged skin cells are in the phase of readiness for the formation of cancer, the use of carcinogenic substances causes its rapid appearance. However, it is extremely important to note that in order to translate a precancerous state into cancer, another condition is necessary: carcinogenic substances or non-specific stimuli must be sufficiently strong, and their contact with the diseased site must be prolonged and systematic. Skin diseases are extremely numerous. To treat precancer impossible. They arise from various causes, but the main ones are the harmful effects of long-existing irritating factors of the external environment, as well as factors of the internal environment. Among the harmful environmental factors that affect the skin, there are groups of non-specific and specific stimuli. Non-specific factors include physical (excessive insolation, up to the appearance of sunburn on the skin, constant exposure to wind and rain, increased dustiness of the air) and chemical (smoke, coal dust and air gases of large industrial cities, various cauterizing substances, including medicinal ones, with excessive consumption). Specific stimuli include a group of various microscopic fungi and bacteria. Hygiene measures that protect against skin diseases are relatively simple. First of all, you need to monitor the condition of your skin. Some people have dry skin (sweat and sebaceous glands secrete very little), while others have oily and sweaty skin (the glands secrete a lot or an excessive amount of secretions). Dry skin should be lubricated with fresh butter, cream, glycerin, lanolin and various creams that are mixtures of skin softening substances. People with oily skin should often wash it with hot water up to 30-32 °C with neutral Soaps. In this case, not only the surface fat is dissolved, but also under the influence of heat, the excretory ducts of the sweat and sebaceous glands are opened and the stagnant secret is washed out. If the skin is functioning normally, it is enough to wash in the morning and evening with cold water and soap. As for the various chemicals used to remove fat from the skin, they should not be used too often, since they cause tanning of the skin, close the excretory ducts, lead to dry skin, cracks, rapid exfoliation of the stratum corneum, the formation of foci of irritation, etc. Strictly observe skin hygiene should be people who have the conditions of the profession, it is smoke or dust. Such people need to wash their hands and face thoroughly after a working day, paying special attention to the natural folds of the skin, depressions, wrinkles, where chemicals are very firmly deposited, mixing with dust. After washing with warm water and neutral soap, it is necessary to RUB the skin softening substances. People who are extremely sweaty and who have rapidly decomposing sweat and fat accumulating in the armpits, groin folds, and perineum should wash these parts of the body with soap and water every day and lubricate them with various tanning agents, as well as powder them with rice powder. This prevents the formation of dermatoses, eczema rashes, papillomatous and other growths in these places. Currently, it is established that not all skin diseases are precancerous. Below I will tell you about precancerous skin diseases that, if not treated in a timely manner, can turn into cancer. Let’s focus on specific diseases. Do not be afraid of unknown terms, I will describe everything in detail, so that you understand.
Xeroderma pigmentosa. This is a disease of young age, which consists in excessive, abnormal sensitivity of the skin to sunlight in the presence of a large number of pigment spots in the skin, resembling large freckles. The cause of the disease is still considered unclear, although it is assumed that it occurs due to congenital inferiority of the skin. Some scientists believe that in this disease, some substances with photochemical properties are formed in the skin. It manifests itself in the first months after birth, and initially there are limited redness of the skin in the area of uncovered parts of the body, especially on the face, which quickly turn into pigmented spots that resemble large freckles, gradually covering the entire face. Skin with the development of the disease becomes atrophic, dense, shiny, it is difficult to gather in a normal fold. Small dilated surface blood vessels appear between the pigment spots. Sunlight causes the formation of dark bumps on the skin – the so-called ephelites. With further development, a large number of extremely dark pigment spots are formed. In the area of these age spots, as well as in those places where there were ephelites, large warty elevations develop, which later often turn into cancer. These same characteristic features are also characteristic of senile skin that was normal in youth, which can also undergo all the changes described in the pigmented xeroderma of young people. Prevention consists of protection from direct sunlight. For limited xeroderma and individual tumors, surgical treatment is recommended.
In Bowen’s disease, lentil-like flaking spots appear on the skin, resembling large patches of red lichen planus. Their appearance is diverse: sometimes they look like lentil-shaped cakes, then they look like coin-shaped disks of pale pink color, infiltrated and covered with crusts and scales. The disease almost always eventually turns into cancer, and the tumor that arises from these spots quickly develops and gives metastases (transfer of the painful beginning) to the internal organs. The cause of Bowen’s illness has not yet been determined. Some scientists believe that it arises from birthmarks, while others attribute it to symptoms of an inflammatory process in the sebaceous and sweat glands. In any case, all scientists agree that this is a precancerous disease. The most reliable surgical removal of lesions with a conventional surgical knife or electric knife. Radiation therapy is also used, but with less effect.
Senile keratoses occur in older people on the skin of the face and less often on the hands. The skin of such patients is yellowish, with numerous yellowish-brown elevations, pigment spots interspersed with small whitish areas, wrinkled, dry to the touch, and atrophic. It also forms warty growths with a rough surface that itch strongly and bleed easily when trying to scratch or RUB. At the heart of this disease is skin atrophy, in which the deep layers of the skin change and turn them into connective tissue fibers. Skin atrophy precedes the appearance of precancerous and cancerous tumors. Senile keratoses occur more often in people with oily than dry skin. Then there are cracks, ulcers. Keratodermia often go into cancer. In the presence of new skin diseases, workers in the arsenic industry should switch to work that is not associated with chemical irritants. Warts and growths must be removed or treated with medication. Skin cancer can occur due to prolonged contact with paraffin. Paraffin cancer has a precancerous stage, which can be quickly cured after changing the profession and appropriate treatment. With long-term occupation of the paraffinist profession, first there is an increased growth of the epidermis, the activity of the sebaceous glands of the skin increases. The growth of the epidermis leads to the formation of small nodules or flat, dirty-brown crusts. At first, this is just an inflammatory dermatosis, which can then turn into a chronic form, and the skin darkens (pigmented), becomes brittle, cracks, and warts appear on it. As soon as such irritations are formed, you should immediately change your profession. These dermatoses and warty growths pass quickly during hygiene measures. Precancerous tar dermatoses occur in people whose work is associated with the dry distillation of coal, with its gaseous and solid products. When all these substances act on the skin, precancerous diseases can occur, which include primarily dermatitis and papillomas. They appear more often during the first years of work in production. Timely elimination of contact of workers suffering from precancerous diseases with irritating substances leads to the disappearance of tumors and reduces the risk of cancer. For this purpose, medical preventive examinations are carried out at industrial enterprises. Personal hygiene is of great importance in the prevention of precancerous skin diseases – frequent washings and baths, protective clothing, protective hats and glasses, powdering or smearing the skin with cream before starting work. In Russia, such diseases are extremely rare, since harmful substances are eliminated from production or are reliably sealed, working rooms are well ventilated, dust and chemical vapors are sucked out of the workshops, and sanitary and educational work is carried out among workers and employees of industrial enterprises. However, it is necessary to have a conscious attitude of the workers and employees themselves to measures of personal and General prevention of precancerous diseases and their timely treatment. Professional radiation damage to the skin is currently almost non-existent due to the use of appropriate protective devices. In pre-revolutionary Russia, they were widely known and carefully studied. People working with x-ray and radium installations often developed chronic dermatitis, which was manifested initially in the form of acute inflammation of the skin (on the hands, phalanges of the fingers, less often on the forearm, face and genitals), which was quickly cured or turned into a chronic one. This is precancerous
the disease is well treated with various conservative methods under the condition of changing the profession.
Papilloma is a papillary skin tumor that resembles a wart. It occurs most often in middle-aged and elderly people, and can exist for a long time without causing concern to the patient, if it is not subjected to trauma. When injured, the papilloma begins to inflame, bleed, and there is a danger of its transition to a malignant tumor. Some people who have papillomas sitting on a small leg (so-called hanging warts), pull them with thin silk threads, after which such a tumor turns black, deadens and is rejected. However, this method is dangerous: if some malignant cells appear in this papilloma, they remain in the” root ” of the tumor, from which a malignant neoplasm can develop in the future in people of a relatively young age (40-50 years) with very oily skin. Treatment consists of careful care of the skin of the elderly, especially not covered with hair and clothing. Atrophic dry skin should be lubricated with emollient creams and protected from excessive exposure to sunlight. Oily skin should be washed several times a day with warm water to remove sebaceous layers, along with dust particles and other clogging and irritating substances. The cutaneous horn is a formation with an extremely dense epithelial layer that grows in the form of animal horns, but differs from it in the absence of a cutaneous substance. It is regarded as hyperkeratosis (excessive keratinization of the skin). As a rule, the skin horn appears as a single horn, mainly on the face or head, much less often on other parts of the body. Located on the nose, it gives the face a whimsical shape. The skin horn is formed as a result of a local metabolic disorder in the skin, on the basis of which a rapid, abnormal keratinization of cells begins with their growth one on top of another in the form of a protrusion. If the metabolism in the skin is slightly disturbed, then such skin horns can exist for a long time, without turning into cancer. If there is a metabolic disorder not only in the skin, but also in the entire body, the skin horn can turn into cancer. The treatment is surgical, and not only the skin horn itself is excised, but also the healthy tissues surrounding it. Various destructive fluids are also successfully used. Occupational skin diseases usually include a number of precancerous diseases and those cancers that occur much more frequently in working people under certain professional conditions than in other groups of the population. In Soviet reality, it is almost impossible to study and observe cases of occupational cancer, since the labor protection conditions created by our party and the government exclude direct contact of workers ‘ skin with a substance that can cause cancer. Chemicals can cause the occurrence of precancerous diseases-dermatoses and dermatitis, which is proved by observation and numerous experiments on animals.
Occupational chemical hazards are created from exposure to chemicals such as soot (mainly coal), oil distillation products: crude kerosene, crude paraffin, Scotch oils, products of coal and coal tar distillation, as well as their derivatives (creosote, anthracite, aniline), arsenic (a component of arsenic-containing minerals, mineral dust), coloring agents and other items made from arsenic or from compositions that include arsenic.
Cases of professional precancerous dermatoses occur as a result of prolonged skin irritation with the above chemicals. The appearance of precancerous diseases, as well as cancer from these occupational hazards is directly dependent on the length of work with this substance and the age of the worker. Asphalterers and briquetters sometimes have precancerous processes on the skin, mainly of the face, forearm and hands, 15-20 years after the beginning of this profession. As a result of prolonged exposure to arsenic and creosote preparations, precancerous diseases begin to be detected 15-20 years after the start of exposure. Cancer on their soil occurs a few years later. This indicates that the development of skin professional cancer requires a long-term, measured two to three decades, skin irritation. Cancer from exposure to coal tar is also preceded by non-cancerous skin diseases. Occupational cancer in people working in the arsenic industry can occur due to inhalation of arsenic, as well as direct skin contact with arsenic. Arsenic keratoderma occurs mostly on the extremities, especially on fingers.
Lupus vulgaris (tuberculosis of the skin) is a disease that in adverse cases can turn into cancer. Such adverse moments are frequent irritation of the skin affected by lupus, various chemical, thermal, radiation and mechanical factors. In typical cases, lupus is located on the face, capturing the back of the nose and the adjacent part of the cheeks, and is a red area covered with Horny scales. In other cases, it appears as warts, and affects the fingers from the back surface: the hands, soles, heels, etc. The skin is a dirty brown color with a blackish tinge, it has a large number of cracks, from which pus droplets are released. On the periphery, these foci are surrounded by a red roller. To the touch, it is dense, rounded, crusts and scales are full-blooded, very dense and are removed with great difficulty. It should be remembered that lupus vulgaris is aggravated by ultraviolet rays, so patients should avoid the sun, especially in the spring. In some cases, with a limited process, surgical removal of lesions, x-ray therapy, and electrocoagulation are indicated. Persistent and persistent treatment usually leads to recovery. The next form of skin lesions with tuberculosis is miliary tuberculosis of the skin, which is usually observed in patients with pulmonary tuberculosis on the mucous membrane of the oral cavity, on the skin near the anus and in the perineum. The ulcer has pitted edges, the bottom is covered with a greasy-bloody liquid; in the circumference of such an ulcer, there are almost no inflammatory phenomena. The process tends to grow along the periphery, and atrophic scars remain in the center. The disease is more common in middle age. Lupus vulgaris and miliary tuberculosis of the skin with unsystematic treatment can turn into cancer. Long-term fistulas with scarring changes in the skin around them can also be the ground for the occurrence of cancer. The predisposing factor to the appearance of cancer on the skin surrounding the fistula is the constant release of pus from them, irritating the scars. At first, ulceration appears on these scars, then wild meat increases, which should be immediately removed. Fistulas are most often located on the shoulders, less often on the forearms, then on the legs, face, and finally the trunk. The age of the patient in this case does not matter much, but the longer there are fistulas, the more important age is when they pass into cancer. A particularly important role in the malignancy of such scars is played by sharp fluctuations in temperature, as well as changes in the nutrition of the entire body, which is expressed in a violation and disorder of metabolism. When treating, it is necessary first of all to eliminate the causes of fistula formation (osteomyelitis of the bone, bone fragments, foreign bodies, tuberculosis of the bone, etc.). Scars resulting from burns can become a breeding ground for cancer, especially if they are constantly affected by excessive heat. As a result, ulcers are formed, which are regarded as chronic precancerous changes. Irritation of the scar by constant friction of clothing or frequent traumatic injuries, caustic substances leads to the appearance of erosion (ulcers) on it, followed by bacterial contamination. In such cases, independent recovery is very rare. With the long-term existence of such ulcers, their transition to cancer is possible. Glass blowers with many years of professional experience may develop precancerous diseases at the site of hand or face burns. The use of preventive and curative measures led to the fact that this group of workers managed not only to cure these precancerous diseases, but also to prevent their further appearance. Angiomas and hemangiomas are malformations. These are tumors from small vessels. They mostly develop in childhood and are only rarely found in adults. They are different forms of education, often in the form of small, barely noticeable spots. They are often multiple. If angiomas are located directly on the skin, they are called subcutaneous, under the skin-subcutaneous. Sometimes the deep subcutaneous angioma occupy a large space. Their favorite location is the skin of the head and face, but they are also found on the skin of the upper extremities, buttocks, and thighs. More often, angiomas affect women. Under the influence of any permanent stimuli (burns, blows, edema, inflammation), angiomas can ulcerate and bleed, and their tendency to malignant degeneration is noted. Small and not very common hemangiomas are reliably treated by using cryotherapy or electrocoagulation. Moreover, there is not only a decrease, but also complete disappearance of tumors. It should be noted that after healing, there are small, quite satisfactory in cosmetic terms, scars that are particularly well cured in children. These scars change so much during the growth period that they are almost invisible. There are an extremely large number of people who carry birthmarks-nevi. These age spots do not pose any significant danger with regard to the possibility of cancer arising from them, if they are not located in places that are subject to frequent trauma: on the hands, in the armpits, on the neck in the collar area, in the inguinal folds, on the back of the foot, etc.sometimes 2-3 traumatic injuries, especially accidental skovyrivaniya or combing of nevi, are Enough for them to turn into a malignant tumor, so-called melanoma. Therefore, flat or warty pigmented and non-pigmented formations that are located in places that are subject to frequent minor trauma should be removed. Age spots that are located in places that are not subject to injury (on the face, head) should be removed only when they begin to become inflamed, increase in size, and disturb the patient with itching. In these cases, do not delay, you should consult a doctor. Skin diseases such as warts, pimples, eczema spots, long-existing seals, with frequent irritation or permanent injury, can turn into cancer. Patients should be warned against scratching, peeling, and squeezing these formations. Also contributes to the occurrence of precancerous skin diseases smearing these formations with iodine, lapis, copper sulfate and other cauterizing substances.