Facial Skin Lesions, Skin Cancers And Their Management

There are many types of skin cancer, with basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and malignant melanoma (MM) being the most commonly mentioned. Whilst chronic sun exposure is one of the main risk factors for skin cancer formation, other pre-disposing conditions include genetic preponderance as well as exposure to radiation and certain chemicals. BCC is the most common type of skin cancer, and along with SCC, is much less likely to spread to other parts of the body. However, they can be locally destructive and should be dealt with early to prevent the need for major surgery at a later stage. BCC commonly presents as a raised skin lesion with rolled borders, while SCC presents with ulceration and bleeding.

 

MM is the most feared form of skin cancer as it has a high risk of spread to the lymph nodes and other organs in the body. Whilst there are many subtypes of melanoma, it commonly presents as a black spot with irregular borders, forming and growing over weeks rather than months. MM should be excised with appropriate margins which are dependent on the depth of skin invasion of the cancer. Adjuvant treatments such as chemotherapy may be required depending on the extent of the MM.

Whilst there are some medical treatments available skin cancers, surgical excision is the mainstay of treatment. An incisional or excisional biopsy can help to determine whether a skin lesion is malignant. A clinical assessment of the lymph node basins may also be involved, and further investigations such as blood tests or X-rays and scans may be ordered.