The symptoms of skin cancer

introduction

The symptoms of malignant skin changes are insidious and are often not recognized and interpreted by medical laypeople or only too late.
There is either no pain with malignant skin changes or only when the skin has been streaked with malignant tumor tissue for a long time. Pain in the early stages of tumor formation almost never occurs.

More information can be found here: White Skin Cancer

The leading symptoms of malignant skin changes are rapidly changing pigmented areas on the skin.
In most cases, it is long-standing birthmarks, to the sight of which those affected have already become accustomed, that change their shape, color and size.
In dermatology there is the so-called ABCD rule:
A stands for asymmetry, i.e. Birthmarks change asymmetrically and, for example, grow strongly on one side, become oval or angular, sometimes the otherwise straight structural boundaries are also interrupted.
B stands for border, i.e. the edges of the suspicious area become uneven, angular or interrupted.
C stands for the color, i.e. the color of a suspicious skin area is not monotonous, but rather restless with rapidly growing skin tones.
D stands for the diameter, which changes rapidly and becomes larger.
If one or more of the ABCD factors apply to a suspicious skin area, there is a high probability of a malignant degeneration of the area. In this case, a skin biopsy should definitely be taken. Since there is a risk of cell carryover in the event of malignancy, in most cases the entire stain is cut out and examined histologically in medical pathology.

Another “symptom” of a malignant skin disease is a familial accumulation of skin cancer cases in recent years.
Since it is known today that cancer, including skin cancer, is partly passed on genetically and thus the risk of cancer increases in a person if cancer of any kind has occurred in the family and close relatives in previous years , has come, questioning the patient is particularly important if there is a suspicion of developing skin cancer.

Furthermore, the patient should be asked whether he belongs to a risk group for skin cancer. This includes years of sunshine enjoyment on midsummer days, protected or unprotected.
In addition, patients who frequently and regularly visit tanning salons are also at risk of developing skin cancer in the course of their lives.

Due to the often unspecific symptoms, a biopsy should always be obtained in case of doubt.

Recognize the skin cancer

Many skin changes can be treated well if they are recognized early. But that is exactly where the problem lies. Early detection is particularly important in malignant melanoma, which is usually mentioned when skin cancer is mentioned, as it grows and metastasizes quickly.

Since July 1, 2008, all those with statutory health insurance in Germany aged 35 and over have been entitled to an early skin cancer screening test every two years. This should especially be used when you are exposed to a lot of sunlight. During this examination, a special examination light, the dermatoscope, is used, which also facilitates the detection of degenerated tissue.

But even as a layperson, you should regularly take a closer look at your own skin, after all, you know your own skin, that of your partner or children, best. Regular self-examinations are particularly recommended if, as already mentioned, you are exposed to a lot of sunlight, have an increased risk of skin cancer for family reasons, or have a very light skin type. You can also use a mirror to get a good look at body parts such as the back, neck, buttocks and soles of the feet. Areas of the body that are not exposed to the sun, for example the oral mucosa or the anal region, can be affected by skin cancer as well as others.

Read more on the subject at: How do you recognize skin cancer?

In order to better assess your skin and detect skin cancer earlier, you should pay particular attention to two things.

• First, pay particular attention to changes in your skin. If you notice "liver spots" that you did not know before, you should go to a dermatologist and have the area examined. Of course, there are also numerous benign skin changes, such as age spots. However, if a particular stain seems strange to you, have it further clarified.
• Second, look for the "ugly duckling"Since most people have significantly more than one mole, it is especially important to watch out for moles that are different from the rest. If in doubt, it is better to have them removed.

Also noticeable are skin areas that are permanently reddened and itchy. Marks that also bleed or change in shape and size are particularly suspicious and should be presented to a dermatologist as soon as possible.
Read more on the topic: Detect skin cancer

ABCD (E) rule

Being able to judge moles yourself is important; especially if you have a lot of moles and / or a light skin type. In particular, one should pay close attention to one's skin even if there have been cases of skin cancer in the family. The malignant (maliciousMelanoma is responsible for most of skin cancer deaths because it grows and metastasizes quickly. This degenerates the skin cells that form the pigment melanin. The ABCD rule is a very useful aid for self-examination and early detection of melanoma. Skin changes are assessed according to the following points:

• A (asymmetry): Melanomas are often characterized by an irregular contour, especially in the early stages.
• B (limitation): this is one of the most important abnormalities. The transition between melanoma and healthy, normally pigmented skin is often fluid or jagged. Normal moles, on the other hand, are sharply demarcated from the surrounding, normally pigmented skin.
• C (Color): Even a conspicuous shade can indicate a degeneration of pigment spots. Melanomas often have a very dark, black to bluish or even gray color. Often times, multiple colors appear within one time in melanoma.

For more information, we recommend our website to: Black birthmark - how dangerous is it?

• D (diameter): Pigment spots with a diameter of more than two millimeters require special attention and should be clarified more precisely if in doubt.
• E (majesty): If a mole bulges out, this can also be noticeable. Although this sign is less suspicious than the previous ones, it should nevertheless make you suspicious if it occurs in combination with several of the other signs.

Neither of these signs alone is a safe diagnosis of malignant melanoma. In combination, they are always suspicious. Marks that bleed, itch or change in shape and size are particularly noticeable. If in doubt, you should not be afraid to seek medical advice. It should also be noted that the ABCD (E) rule only applies to melanoma as a special form of skin cancer. Other types of skin cancer sometimes have completely different characteristics.

Itching as a symptom of skin cancer

In addition to the more well-known symptoms, such as an irregularly limited black mole, other symptoms of the onset of skin cancer appear much earlier and more frequently. If the skin is permanently reddened, flaky or itchy, this should make you suspicious. Especially white skin cancer with its two sub-forms, basalioma and spinalioma, is conspicuous in the early stages due to these three symptoms. Since it rarely metastasizes, surgical removal is often quite possible. However, timely detection is a prerequisite for unproblematic removal.

However, other types of skin cancers can also attract attention primarily through persistent itching. The type of skin cancer, which is usually referred to in the sense of skin cancer and which is responsible for by far the largest number of skin cancer deaths, is malignant melanoma. At the beginning it often reminds of a mole. However, it can become noticeable by bleeding or itching. Should you discover such a "mole", you should urgently consult a dermatologist.

Symptoms on the nose

Skin cancer occurs mainly in places that are often exposed to solar radiation. These are mainly:

• forehead
• Cheeks
• Bald head
• Ears or also the
• nose

In particular, white skin cancer with its sub-forms of basalioma and spinalioma develops in these parts of the body. In the initial stage, it appears as a slightly reddened spot, which can also be raised, but in many cases it can also be flat. As the disease progresses, the white skin cancer becomes increasingly crusty and in many cases begins to bleed. If such changes appear on the nose, this is in urgent need of clarification.

The first-line measure to prevent white skin cancer on the nose or other parts of the body is simple:
Light protection. The use of sunscreen is not only recommended for people with fair skin types. Anyone who is exposed to the sun for long or regularly should protect their skin with sunscreen. Above all, adequate protection of the facial region must be ensured.

Birthmark / mole

Birthmarks or Moles (Pigment nevi) are usually benign growths of the pigment-forming skin cells, the melanocytes. However, the term birthmark is also used as an umbrella term for benign pigmentation disorders caused by red blood vessel cells, yellow sebum cells or other other types of cells.
Especially in Austria, Bavaria and the Switzerland the word birthmark is used synonymously for moles. Birthmarks and moles can be congenital or develop in the course of life. The number of liver spots a person has is on the one hand genetically determined; On the other hand, the time that you spend unprotected in the sun as a child also plays a decisive role. Pigmentation disorders can also occur more frequently during pregnancy.

Although birthmarks are usually benign changes in the skin, they can also degenerate and develop into skin cancer. Pigmentation disorders that change in shape, size and color are particularly dangerous. The ABCD (E) rule (see above) provides assistance in identifying primarily malignant melanomas. People who develop a large number of birthmarks are particularly at risk of developing skin cancer. People with known family history of skin cancer are also at a higher risk of developing skin cancer and should check their skin carefully.

Types of skin cancer

The basalioma

Basaliomas are mainly found on the skin centrofacial, i.e. in the region of the face from forehead to upper lip (80% of cases). This skin cancer is found somewhat less often in the lower half of the face or the upper forehead (15%).

The growth takes place slowly over a period of months to years and is locally destructive, i.e. destroying the surrounding structures. Compared to spinaliomas, basaliomas develop more slowly.

A metastasis of this skin cancer (spread of the cancer cells) almost never occurs, which is why basaliomas are also known as semi-malignant („semi-malignant“).

The incipient form of this skin cancer usually presents itself as a skin-colored knot of coarse consistency with a pearl-like edge wall and small vascular dilatations (Telangiectasia).

There are several different forms of "basalioma" skin cancer, some of which differ from the typical appearance:

• Solid basalioma
• Cicratizing basalioma
• Scleroderma basalioma
• Pigmented basal cell carcinoma
• Superficial basalioma
• Ulcerating basalioma
• Destructive basal cell carcinoma

• Special shape = metatypical basalioma

The spinalioma

This skin cancer is located on the mucous membranes or the transitional mucous membranes (Lips, tongue, anal region, vulva, penis) and in sun-exposed areas such as the head, neck, arms and hands.

As with basalioma, growth is destructive, but time can vary more widely (Weeks to years).

Metastasis occurs mainly via the lymphatic system (lymphogenic) and only rarely via the bloodstream (hematogenous).

In terms of shape, the skin cancer "spinalioma" is rather inconspicuous. This type of skin cancer looks skin-colored to brown, has a firm consistency and can have a keratinized surface. The changes are not painful, but can become lumpy or ulcerated over time.

Malignant melanoma

The skin cancer "malignant melanoma" is most common Back, face, back forearms and in women also on the lower leg. All other parts of the body can also be affected by this skin cancer.

Malignant melanomas grow invasively and initially flat (horizontal), then nodular in depth (vertical).

Metastasis of this skin cancer usually occurs early on, both via the blood (hematogenous) as well as via the lymphatic system (lymphogenic). The daughter tumors of this type of skin cancer settle in other areas of the skin or subcutaneous tissue, lymph nodes, lungs, liver, brain and bones.

One can recognize malignant melanoma with the help of the ABCD rule: You are asymmetrical (A = asymmetry), out of focus (B = limitation), pigmented to varying degrees (C = coloring) and have a Size over 5mm (D = diameter). Itching and spontaneous bleeding can also occur.

This type of skin cancer is divided into 4 different types:

1. Superficial spreading malignant melanoma: 65% of cases; Peak among 50 year olds; Localization mainly in sun-exposed areas; Color light brown to black, rarely gray or white; First flat, later nodular
2. Primary nodular malignant melanoma: 15% of cases; Summit among 55 year olds; Occurrence mainly on parts of the body exposed to light; rapid aggressive growth; Color dark brown to black
3. Lentigo maligna melanoma: 10% of cases; Summit among 68 year olds; Localization mainly on the face and back of the hand; rather slow growth; Color dark brown to black; Flat and large in shape, 2 to 6 cm in diameter; Beginning as a precancerous disease "Lentigo maligna"
4. Acrolentiginous malignant melanoma: 45% of cases; 63-year-old summit; Occurrence on the nail bed and acra; Color: Black; Nodular shape

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