Yeah, yeah, yeah, blah, blah, blah…one of my favorite quotes from a derm I know. I don’t find the ABCDE rule that helpful because there are plenty of benign lesions which would fit these criteria. My favorite way to explain it is “The Ugly Duckling” rule. Look at your moles, the ones that stick out like the ugly duckling are the ones usually to be concerned about. The most sensitive criteria tends to be color (black, very dark brown/black), though there is a rare variant of melanoma known to be colorless or red.

75% of melanomas arise spontaneously without a pre-existing mole, and they can arise quickly. Every year I find some of my established patients I’ve been checking for yearly for years all of the sudden present with a new black lesion, sometimes in the earliest stages, or already invasive. Scary. The good news is that melanomas caught in the earliest stages have an excellent prognosis.

In addition, anyone with a personal or family history of skin cancer, should not only worry about themselves, but also their family members. Remind them to get checked as well!

Also, although embarrassing, I do encourage everyone to have a total body skin exam (I do mean total as in the genitals and perianal area). Once in a blue moon, we do find cancers there, especially from STD’s such as genital warts which are fairly common. Looking down there also reminds me to remind you to get screened for other cancers starting at age 50 (or earlier if you have symptoms or a family history) which are common and curable, such as colon and prostate CA. Also, a lot of older women forget about cancers of the reproductive system which can be aggressive if caught too late.

http://www.medwire-news.md/66/89386/Dermatology/Basal_cell_carcinoma_on_the_rise_in_Europe.html

Thanks to the staff involved with both screenings which were well-organized and fun.

Skin Cancer Foundation Road to Healthy Skin

The shame of it all is that like melanoma, it is highly curable in the earliest stages. Unlike melanoma, we do have solid proof that sunscreen can make a difference. Unfortunately, we have at least one patient a year who either succumbs to this disease, or comes very close to it. We have seen a number of difficult and aggressive tumors, particularly in older white men and transplant patients.

It is always helpful to come in for a yearly check-up and to not ignore or pick off scaly lesions. The precursor to many SCC’s are precancers called actinic keratoses and are easily treated with freezing or chemotherapeutic creams.

• 1 out of 5 Americans will develop skin cancer within their lifetime
• The two major forms of non-melanoma skin cancer are basal cell carcinoma and squamous cell carcinoma. 40-50% of Americans age 65 and up will have either basal cell carcinoma or squamous cell carcinoma at least once
• In the last 30 years, the number of women under age 40 diagnosed with basal cell carcinoma has doubled and the number diagnosed with squamous cell carcinoma has also increased

Both basal cell and squamous cell carcinomas are often diagnosed late because they can look like anything, e.g., a scaly spot, pimple, wart, or cyst, so it is important to have a skin exam.