I want to say that skin cancer began to show its “power” at the turn of the XX and XXI centuries, which, I believe, is due to the deterioration of the environmental situation. Skin cancer is one of the most common forms of malignant tumors, affecting men and women equally, mainly over the age of 50 years, usually in open areas of the body. The incidence of skin cancer is about 5 % of the total incidence of cancer. Skin tumors are one of the most common forms of neoplasms.
Among them can be distinguished such as benign tumors, basal cell carcinomas-tumors that cause the destruction of adjacent tissues, malignant tumors-cancers. It is rare to find cancer from the components of the skin-sebaceous, sweat glands, hair follicles.
The causes of skin cancer can be excessive sun exposure, external carcinogenic effects (x-rays, some chemicals). Precancerous diseases should be considered albinism, long-term ulcers, extensive scars and chronic precancerous processes – pigmented xeroderma and lupus, radiation dermatitis, pigmented xeroderma and others, which I have already described above. Skin cancer can develop anywhere, somewhat more often on the face (back and wings of the nose, corner of the eye, forehead) and on the trunk in the armpit area, although it often affects the foot, Shin or hand.
In this case, the patient can observe the following symptoms – the appearance of a painless dense one or several merging nodules of pinkish-yellowish waxy color, sometimes with pearly translucent edges. The tumor progressively increases and quickly ulcerates. Only some forms of skin cancer (basal cell carcinoma) show very slow growth, sometimes existing for many years without visible changes. As the tumor develops, its fusion with the underlying tissues occurs and the formation of a dense stationary infiltrate. A common sign is concomitant pigment spots. Sometimes the precancerous formation does not change in any way, but metastases to the lymph nodes appear. Squamous cell carcinoma is flowing slowly, but in the later stages usually occur regional and distant metastases. In rare cases, skin cancer proceeds aggressively (relapses with rapid growth, early metastasis to the lungs, bones and other tissues).
In order to recognize this disease, the patient must undergo a course of examination. A thorough examination of a tumor suspected of cancer is carried out through a magnifying glass. To confirm the diagnosis, they resort to a radioisotope study, determining the accumulation of radioactive phosphorus, which in cancer reaches 300-400% compared to a healthy area of the skin. The main method of recognizing this form of cancer is cytological examination of prints from an ulcer or punctate from dense areas of the tumor, or a biopsy, in which a piece is excised in the form of a sector, capturing healthy tissue along the edge. To exclude the presence of metastases in the internal organs, ultrasound (ultrasound), radiography and computed tomography (CT) are used.
The next form of skin cancer that I would like to talk about is basal cell carcinoma. Basal cell carcinoma, like skin cancer, is significantly more common in rural residents than in urban residents, especially in the southern regions, because the intensity of solar radiation and time spent outdoors are important risk factors for the development of these tumors. Basal cell carcinoma is equally common in women and men, mainly in the elderly. It is the most common skin tumor and accounts for 70-75 % of the various tumors that develop from the epithelium, i.e. the outer layer of the skin. Most often, basal cell carcinoma is located on the face, less often on the trunk. Often there is a multiple lesion of basal cell carcinoma of various skin areas.
The clinical manifestation of this tumor is quite diverse. Initially, the basalioma has the appearance of a dense nodule the size of a lentil grain, protruding above the surface of the skin. The color is pinkish, pinkish-yellowish or matte-pale, resembling a pearl. With pigmented basal cell carcinoma, the nodules have a darker color: bluish-brown or brown-white. In the future, if no treatment is carried out, ulceration may occur, with an erosion with an uneven bottom or a deeper ulcer with crater-like edges forming in the center. Gradually, the ulcer spreads both over the area and in depth, destroying the underlying tissues. Sometimes a tumor forms on a wide or narrow base, protruding above the surface of the skin. The development of basal cell carcinomas is usually long and slow. With ulceration, the course of the disease is complicated by the addition of infection and an inflammatory reaction in the circumference of the tumor: swelling, redness, swelling, itching may be.
For correct recognition of the tumor, it is important to carefully collect anamnesis (the presence of occupational hazards, lifestyle, previous skin changes, the sequence of tumor development, etc. Cytological and histological studies are used to clarify the diagnosis.
Finally, the last, most common type of skin cancer is malignant melanoma. Malignant melanoma is one of the most malignant human tumors that occurs at any age, often in young people, somewhat more often in women. It is from 0.3 to 1 % of all cases of cancer. The incidence of melanoma has been growing rapidly over the past few decades and accounts for 2.5-10 % of all newly detected skin tumors. It arises from cells that produce the pigment melanin, so in most cases it has a dark color, but it can also be unpainted. It is most often localized in the skin (90 %), rarely in the conjunctiva, nasal mucosa, oral cavity, vagina, rectum. The background for its occurrence is often congenital pigment spots-nevi, especially re-traumatized, when they are located on the back, in the area of the upper arm, on the foot or open parts of the body. Even more dangerous are melanomas that develop against the background of acquired pigment spots found in patients in adulthood. Among the risk factors – significant doses of ultraviolet radiation, family predisposition to melanoma, xeroderma pigmentosum. Hairy nevi are never malignated; if hair growth is visible on a pigmented tumor, it should not be classified as malignant.
In 50-70% of cases, skin melanoma occurs from a pigmented birthmark (nevus). It is more common on the skin of the head, neck, and limbs. Frequent localization of the tumor in men is the back, chest and upper extremities, in women-the chest, lower extremities. The most dangerous nevus, which is more common on the skin of the scrotum, palms, soles. Signs of malignancy: increase in size, bleeding, color change-strengthening or, conversely, weakening of color, as well as infiltration around and under the base of the nevus. Clinically, malignant melanoma looks like a dense tumor nodule of intense black color, sometimes with a bluish tinge. Less common are the so-called unpainted melanomas of a pinkish color, devoid of pigment nodules. The size of the tumor varies: from 0.5 to 2-3 cm in diameter. Often, the tumor has a bleeding surface and a compacted base. The presence of such obvious signs is enough to establish a diagnosis by a simple examination. However, in the early stages, malignant melanoma looks more harmless, and it takes a lot of experience to distinguish it from a benign pigmented nevus. As with skin cancer, in addition to examination through a magnifying glass, a radioisotope study with phosphorus is used to clarify the diagnosis, the increased accumulation of which in the tumor confirms the suspicion of its malignancy. Unlike skin cancer in melanomas, it is not recommended to perform a puncture or biopsy, since the slightest injury can contribute to rapid generalization of the process. Therefore, the only way to clarify the diagnosis is a cytological examination of the print from the surface in the presence of ulceration. In other cases, the diagnosis is based only on clinical data. To exclude the presence of metastases in the internal organs, ultrasound (ultrasound), radiography and computed tomography (CT) are used.