Skin cancer is a generic collective term for malignant
diseases that develop from epithelial cells
skin. Skin cancer can develop in every person, of any age,
race and gender. But due to some factors most often this
pathology affects people in a particular risk group. AT
in most cases, the disease is observed in older people after 60 years,
in individuals whose skin type is attributed to the I, II, III phenotype according to
Fitzpatrick, as well as in people of different ages, excessively
abusing sunlight. Malignant are localized
skin lesions are usually found in exposed skin
exposed to ultraviolet radiation.
Skin cancer is the most common tumor pathology.
Unfortunately, statistics on the number of skin cancer cases is inexorable.
“creeps” up. And this can be attributed not only to the inhabitants of tropical
belts, but also to residents of central Russia.
There are several common factors explaining the development of cancer.
skin from residents of different climatic zones:
- Skin cancer develops most often in residents of southern countries. it
associated with excessive insolation, which in southern countries is
all year round. Also, residents of the southern regions of one country have skin cancer.
occurs more often than among residents of the northern regions.
- Malignant skin pathologies occur in people with light
skin, which belong to the I, II, III phenotype by graduation
- The probability of developing skin cancer is increased in individuals who
the reason for working is spending a lot of time in the open
the air under the scorching rays of the sun. This category can be
include farmers, builders, fishermen, etc.
- Causes of development
- Symptoms and types of skin cancer
- Stages of skin cancer
- Skin cancer prognosis
- Prevention of skin cancer
Causes of development
The causes that cause malignant skin lesions are good.
are known. First of all, this is excessive exposure.
ultraviolet radiation on the skin. Scientists have proven that solar
Type A and B rays damage DNA cells, leading to their mutations.
Over time, mutations in DNA accumulate, contributing to the development of cancer
skin. Radioactive radiation, like ionizing radiation, is also
can cause malignant skin disease. Onset of cancer
skin can be caused by thermal effects on the skin (burns,
thermal effects of high frequency current). Carcinogenic
substances: asbestos, benzene, formaldehyde, nitrates, nitrites,
Vinyl chloride, cadmium, mustard, arsenic, can initiate
Thus, it is possible to name with accuracy the factors contributing
development of skin cancer. They are endogenous and exogenous.
- ultraviolet radiation;
- radioactive radiation;
- ionizing radiation;
- thermal effects on the skin;
- effects of carcinogenic substances on the body as a whole, and on
skin in particular.
- age after 60 years;
- genetic predisposition;
- obligate skin diseases;
- optional skin diseases.
Obligatory diseases are a series of skin diseases that
precede skin cancer. These are diseases that are early
or later transformed into cancer. These pathologies are developing
very slowly, very often malignant, but the presence
precancerous background does not yet indicate that he is with a fatal
will inevitably turn into cancer. Malignancy in the condition referred to as
precancer, observed in 0.1-5%.
Obligatory precancerous conditions are:
- precancerous melanosis Dyubreya;
- Bowen disease;
- erythroplasia keir;
- pigment xeroderma;
- Paget’s disease.
Many researchers are inclined to believe that obligate
diseases are not precancerous, but are already in situ cancer
(cancer in place) that does not affect internal or adjacent organs.
But no matter how different the opinions of scientists, these diseases
necessarily need treatment.
Optional diseases can also cause cancer
skin. But if in the case of obligate diseases one can talk about
likely to transform into a cancerous tumor then
an optional precancer is not necessarily going to
malignant tumor. These pathologies require careful
observation and regular examination, but do not need treatment.
Optional pathologies are:
- scars after burns, trophic ulcers;
- scars after lupus, syphilis;
- chronic dermatitis and dystrophic processes;
- senile keratosis;
- the presence of skin horns on the skin;
- damage to warts, papillomas, atheromas.
Symptoms and types of skin cancer
The symptoms of skin cancer can be quite varied and depend on
its type, that is, from the cells from which the tumor has developed. therefore
Consider separately each type of skin cancer, as well as symptoms,
peculiar to each species.
Skin cancer is of the following types:
- basal cell carcinoma or basalioma;
- squamous cell carcinoma;
- metatypical cancer;
Basal cell carcinoma or basal cell carcinoma is the most
often up to 75% of all skin tumors. This type of cancer
develops from cells of the basal layer of the epithelium. Represents
a spot or small nodule that is very similar to an ordinary
birthmark. The knot has a retraction with a crust in the center and a small roller
on the periphery of education. When trying to remove crust formation
ulcerate, leading to ulcers. Over time
the ulcer grows in size, expanding in depth and width.
It so happens that the ulcer itself can heal, however
borders of the tumor continue to grow. Basalioma by many
ordinary people mistakenly interpreted as not too dangerous a disease.
This is partly true. Basalioma practically does not metastasize
but without adequate therapy can lead to severe lesions.
skin integument. In the worst case scenario, it can penetrate
subject and bone tissue, as well as destroy them.
Squamous cell carcinoma of the skin or squamous epithelioma
develops from flat skin cells based on keratinocytes. On
early stages of development resembles the symptoms of basal cell
cancer, but differs from the latter at a faster pace of development.
The tumor is usually localized in open areas of the skin,
who are exposed to aggressive environmental factors
environment. However, squamous cell carcinoma of the skin can appear on
closed areas of the skin (oral mucosa, external genitalia,
anal area). This type of cancer has a more aggressive
character. Symptoms of the disease develop rapidly and progress.
Patients very quickly begin to experience pain. Tumor
has a characteristic roller shape with downward edges, which
resembles a crater view. In the center of education is the sore,
which is covered with a crust, the removal of which produces a ichor.
Education has a dense texture, and the node itself has similarities with
a mushroom. The tumor spreads quickly along the surface of the skin,
penetrates into the underlying tissues and metastasizes to regional
The lymph nodes.
Adenocarcinoma is a malignant tumor that
develops from epithelial glandular cells that enter the
composition of all organs. Therefore, adenocarcinoma can affect any of
these bodies. This type of cancer is very rare. Characteristic
localization at the sites of sebaceous glands: folds under the breast,
axillary and inguinal cavities. It is a small knot.
or tubercle. This type of tumor develops slowly, but as
progression affects nearby organs and significantly
increases in size.
Metatypical skin cancer develops from epithelial cells and
occupies an intermediate state between squamous cell skin cancer and
basalioma. The symptoms of this form of cancer most often do not differ from
symptoms of basal cell carcinoma and correspond to its shape and course. This
pathology in most cases develops in men in the elderly
age Metatypical cancer is most often localized on the face and on
those areas of the skin where basalioma does not occur, for example, on
Melanoma is an extremely aggressive form of skin cancer, which
characterized by rapid metastasis to internal and adjacent
organs. Melanoma develops from skin pigment cells. This view
a cancer never develops from scratch, it always
preceded by some formation on the skin: a pigment spot,
freckle or nevus, in other words, any education, actively
producing melanin. Therefore, with any change in color, shape
or the size of a nevus should consult a doctor. Should mention
one feature of melanoma. When malignancy nevus acquires
in addition to brown, blue, white or red
Although each type of skin cancer has its own
specific symptoms, yet there are a number of common signs,
common to all types of malignant disease:
- asymmetrical form of education, in this case the two sides
tumors have a different shape, color and size;
- fuzzy, jagged borders of the tumor;
- the presence of multi-colored shades in the tumor;
- diameter of a mole more than 6 cm.
Stages of skin cancer
Skin cancer has the following stages:
- The first or initial stage is characterized by the formation of not
more than 2 cm. The tumor is mobile and does not have metastases. However, with this
stages affect the lower layers of the epidermis. Adequate treatment can
lead to 100% cure for patients.
- The second stage is characterized by a tumor size of about 4 cm. When
There are no metastases at this stage, although sometimes doctors find one
metastatic element that is localized in the regional
lymph node. Patients are already experiencing pain, but
competent treatment, the prognosis is quite comforting.
- The third stage is characterized by damage to the lymphatic system,
but the metastases in the internal organs are still absent. Sick
experiencing significant pains and rising
temperature And the tumor itself is already immobile, since it has not sprouted
only in the skin, but also in nearby tissues and has a lumpy appearance.
- The fourth stage is characterized by a large tumor size and
extensive skin lesions. Ulceration on the surface
the tumors bleed, causing the patient unbearable pain and poisoning
whole body. The tumor doesn’t just grow into the internal organs,
but affects cartilage and even the skeleton. Metastases affect
vital organs, especially the liver, lungs and other
organs. The prognosis is poor, the survival rate is extremely low.
In addition to the above stages, melanoma also has a zero stage.
The zero stage is characterized simply by the presence of education on
skin. This form responds well to therapy, and survival with
this stage is almost 100%. This is due to the fact that
only the top layer of the skin, no metastases, and the tumor did not penetrate into
At the moment, modern medicine has effective
methods and means for accurate and early diagnosis of skin cancer.
However, early diagnosis of the disease depends on the patient. AT
case of suspicious skin lesions or
changes to existing nevi must be promptly
consult a dermato-oncologist. The doctor will conduct a clinical
examination, will collect anamnesis, appoint dermatoscopy, ultrasound
lymph nodes, siascopy, biopsy and histological
Clinical examination is performed using epiluminescent
a microscope that makes the stratum corneum transparent
epidermis and with a high probability to determine is
lidan tumor malignant.
If an epiluminescent microscope did not help determine the state
tumor, then prescribe a biopsy. To do this, take a piece of skin
(biopsy) for research. Biopsy can be of several types:
An excisional biopsy is a study of the entire tumor, that is,
it is carried out in case of removal of pathological formation. This
The method is both therapeutic and diagnostic procedure.
An incisional biopsy is the examination of a part of the pathological
education or diffusely modified organ.
If the integrity of the skin above the tumor site is not broken, then
biopsy of the material carried out by the puncture method.
If the biopsy confirmed the presence of atypical cells and high
the degree of their differentiation, then you need to take the following steps to
determine the stage of the tumor:
- to carry out computed tomography;
- magnetic resonance imaging;
- Ultrasound and fine needle aspiration biopsy of the lymph
- cytological examination carried out with
stained smears made from the surface of cancer ulcers
- chest x-ray, abdominal ultrasound, kidney CT scan and
Recent research is needed to identify
distant metastases or deep germination of skin cancer.
Treatment of skin cancer is carried out depending on its type,
stage, location and age of the patient. The basic principle of treatment
Cancer is its removal by a radical method, that is, surgical
excision. Remove the malignant tumor with the seizure of healthy
2-3 cm of skin. Excision is performed using microscopic
intraoperative examination of the border areas of the tumor. AT
In some cases, a tumor can be excised using
carbon dioxide laser.
With tumor mobility and no signs of cancer germination
electrocoagulation is applied to surrounding tissues. When applied
This method of seizure of healthy tissue should be at least 5 cm.
It is also possible to use curettage at the initial stage.
Cryodestruction is used in the case of minimally invasive tumors, with
slight germination of cancer in nearby tissues with capture
healthy tissues of at least 3 cm. Since during
cryotherapy under the influence of liquid nitrogen tumor
collapses and dies. Therefore, all diagnostic measures
need to spend before cryodestruction.
Radiation therapy is used for tumors of small size.
A significant drawback of the method is the irradiation of healthy tissue,
and the duration of the treatment (several months). Also ray
therapy is applied after radical removal of the tumor to
suppressing the process of metastasis and in the case of inoperable
Close-focus radiotherapy has a good effect, but this
the method is used only in the case of small tumors.
Drug therapy with cytostatics can be very effective in
pre-and postoperative period, in combination with radiation
A very effective method is micrographic surgery.
MOHS. The essence of therapy is that surgical
intervention is carried out using a microscope. In this way,
the surgeon acts directly on the affected area, removing
not only the affected areas, but also a certain amount of healthy
tissue. This procedure has a high survival rate, and on
the skin is almost no scars.
Also used photodynamic therapy for skin cancer, in which
irradiation is carried out on the background of the introduction of photosensitizers. The
the method is based on the introduction of certain chemicals
which have the ability to accumulate in the tissues of the tumor and under
laser exposure to kill cancer cells with
The method is based on the ability of certain chemical compounds.
(photosensitizers) accumulate predominantly in the tumor
tissue and under the influence of laser radiation cause
photochemical reactions leading to the death of tumor cells.
The main advantages of PDT are: the ability to reuse
treatment, fast healing, good cosmetic effect.
Treatment of skin cancer involves complex therapy when
combines several methods together. The main thing is not to allow
transition of the disease to the last, terminal stage.
Skin cancer prognosis
It should be noted that deaths in skin cancer
are the lowest rates compared with malignant
diseases of internal organs. Natural prognosis of the disease
depends on the stage and type of skin cancer and on how
adequate treatment was carried out in a timely manner. Basalioma least
aggressive form of skin cancer, does not metastasize, responds well
for treatment and has a favorable prognosis. Squamous skin cancer
with adequate treatment is not bad treatment, 5-year milestone
patient survival is up to 95%. Melanoma is the most
aggressive form of skin cancer. The prognosis is unfavorable,
The 5-year patient survival rate is only 50%.
Prevention of skin cancer
Prevention of skin cancer includes the following measures:
- The main and main criterion for the prevention of skin cancer is
protection of the skin from ultraviolet radiation, especially
for the elderly, people with fair skin (I, II, III phenotype
by Fitzpatrick) and small children;
- should use modern sunscreen with
high SPF protection factor – at least 30;
- any formations on the skin that do not heal for a long time should
be sure to show the doctor, such formations are subject to radical
- Avoid contact with carcinogens.
- Avoid injury to nevi that are on
- persons with obligate diseases regularly undergo examinations
doctor and carry out timely treatment.
It should be remembered that early diagnosis of skin cancer will not help
just prolong the life of a person, but also forget about the disease forever.