American Society for Mohs Surgery

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• Basal Cell Carcinoma FAQs

  What Is Basal Cell Carcinoma? » Basal cell carcinoma is the most common type of skin cancer and the most frequently occurring of all cancers. Eight out of every 10 skin cancers are basal cell carcinomas, making this form of skin cancer far and away the most common. They grow in the lowest layer of the epidermis, the basal cell layer. These cancers usually develop on sun-exposed areas, especially the head and neck. They tend to grow slowly and it is rare that they spread to other parts of the body. If left untreated, basal cell carcinomas can grow into nearby areas and invade bone or other tissues beneath the skin, making removal potentially disfiguring. How To Identify Basal Cell Carcinoma» Basal cell carcinomas look like flesh-colored, pearl-like bumps or pinkish patches of skin. They can develop into sores. They tend to grow most often on areas of the skin that are exposed to the sun, such as your arms, face, and neck. Often the first detected symptom of a basal cell carcinoma is a bleeding spot without a preceding cause. It is extremely rare to see regional spread or metastasis to other locations in the body. However, if left untreated, the lesion will expand and destroy more tissue locally where it is found. What Causes Basal Cell Carcinoma? » Basal cell carcinoma occurs when one of the skin’s basal cells develops a mutation in its DNA. Basal cells are responsible for producing new skin cells. As they do so, older skin cells are pushed toward the skin surface, where they die and are sloughed off. DNA in the basal cell controls this function. What Occurs During DNA Mutation? When the DNA mutates, things change. The mutation causes a basal cell to multiply rapidly, and they continue growing when normally they would die and be shed. Eventually, the accumulating abnormal cells form a cancerous tumor that shows as a lesion on the surface skin. Symptoms Of Basal Cell Carcinoma A basal cell carcinoma will show itself as a change in the skin. It can appear as a pearly white, skin-colored, or pink bump that is somewhat translucent. It can also be a brown, black, or blue lesion with slightly raised borders. On the back or chest, a flat, scaly, reddish patch is more common. Where Can It Develop? » Basal cell carcinomas invariably develop on areas that receive lots of sun exposure. They are typical on the head, neck, and arms. Basal cell growths can form on the shoulders, but are less frequent on the lower trunk and the legs. How Are Basal Cell Carcinomas Treated? » How we treat your basal cell carcinoma will often be dictated by its location. There are numerous treatment options. Surgery Surgery is the typical treatment method. Depending on the size and location of the removed growth, the wound may be sutured closed, covered with a skin graft, or allowed to heal on its own. These are the surgical procedures: Electrodesiccation and curettage — With small or superficial basal cell growths, we remove the surface of the skin cancer with a blade or often a scraping instrument known as a curette. Then the base of the cancer is seared with an electric needle. This both closes off blood vessels and kills any stray cancer cells. In some cases, the underlying area is frozen with liquid nitrogen, rather than cauterized with electricity. Surgical excision — This involves cutting out the cancerous lesion with a scalpel, along with a margin of healthy skin around it. The sample is then sent to a lab to confirm that removal was successful. Cryosurgery — Spraying liquid nitrogen onto growths is the preferred method for removing precancerous actinic keratoses, but it can also be used on very thin basal cells carcinomas with little depth. The problem with this method is that the freezing time may need to be prolonged, which can possibly damage nerves in the area. Mohs surgery — This method has the highest success rate of removing all of the basal cell growth. Your surgeon removes the basal cell cancer layer by layer. After a layer is removed, it is examined immediately to check for any remaining cancer cells on the borders. If cancer cells are still found, another layer or ring is removed. This process is continued until the sample shows itself to be clean. This is especially effective for removing growths on the face, as only the minimum amount of tissue is removed. How Successful Is Basal Cell Carcinoma Treatment? » Mohs micrographic surgery has the best cure rates with basal cell carcinoma, a 99 percent cure rate for carcinomas that are not returning growths. The cure rate when basal cell carcinomas are removed with wide excision can be as high as 98 percent. With curettage and electrodesiccation the rate is from 91 to 97 percent. Basal cell carcinoma is not considered life threatening in almost all cases. It is simply disfiguring.

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• Squamous Cell Carcinoma FAQs

  Squamous Cell Carcinoma What Is Squamous Cell Carcinoma? » Squamous cell carcinoma is the second most common form of skin cancer. It forms in the squamous cells that make up the middle and outer layer of the skin. Most squamous cell carcinomas result from prolonged exposure to ultraviolet radiation from the sun or tanning beds or lamps. Unlike basal cell carcinomas, squamous cell carcinomas can occur in more wide-ranging locations. Although more common on the sun-exposed skin on the backs of the hands, the ears, the scalp, and the lips, this form of skin cancer can occur anywhere on the body, including inside the mouth and on the genitals. Not considered life threatening if treated early, like basal cell carcinoma, it can also be disfiguring. If it spreads, it can be life threatening. What Do Squamous Cell Carcinomas Look Like? » Squamous cell carcinomas appear as red scaly patches, scaly bumps, or open sores. Left alone, they become larger and destroy tissue on the skin. They can also spread to other areas of the body. What Causes Squamous Cell Carcinomas? » Squamous cell carcinomas of the skin develop when the flat, thin squamous cells in the outer layer of the skin develop errors in their DNA. In ordinary, healthy skin, new cells push older cells toward the skin surface, where they die and are shed. When the DNA is damaged, the squamous cells instead grow out of control, forming a squamous cell carcinoma. What Are The Signs Of Squamous Cell Carcinoma? » Squamous cell carcinomas are more typical on sun-exposed skin: the scalp, the backs of the hands, the ears, and the lips. But this form of skin cancer can spread anywhere on your body. Squamous cell carcinomas will have these characteristics: A firm, red nodule A flat sore with a scaly crust A new sore or raised area on an old scar A rough, scaly patch on your lip that can become an open sore A red sore or rough patch inside your mouth A red, raised patch or wart-like sore on or in the anus or on the genitals How Are Squamous Cell Carcinomas Treated? » The methods for treating squamous cell carcinomas are the same as for basal cell carcinomas: Surgery Electrodesiccation and curettage — A curette is used to scrap out the growth, then the base is seared with an electric needle to close the blood vessels and destroy any remaining cancer cells. The squamous cell growth needs to be very small for this method to be used. Surgical excision — This involves cutting out the cancerous lesion with a scalpel, along with a margin of healthy skin around it. This is called wide excision. Cryosurgery — Small, superficial squamous cell carcinomas can be frozen with liquid nitrogen. Mohs surgery — This method has the highest success rate of removing all of the squamous cell carcinoma. Your surgeon removes the squamous cell cancer layer by layer or ring by ring around the growth. After a layer is removed, it is examined immediately to check for any remaining cancer cells on the borders. If cancer cells are still found, another layer or ring is removed. This process is continued until the sample shows itself to be clean. This is especially effective for removing growths on the lips, as only the minimum amount of tissue is removed. What Is The Success Rate For Treating Squamous Cell Carcinoma? » Unlike basal cell carcinoma, squamous cell carcinoma tends to be more invasive and is likely to spread if left untreated. As with basal cell carcinoma, Mohs micrographic surgery has the best success rates, at 97 percent. Excision has a 92 percent success rate. For low-risk, small tumors, curettage and electrodesiccation is successful in 96 percent of cases, but it cannot be used for larger, deeper growths. Drugs Although the squamous cell carcinoma needs to be relatively small and superficial, topical treatments can be successful. These drugs work by inflaming the area where they are applied. The body responds by sending white blood cells to attack the inflammation. These white blood cells go after the mutated basal cells. Aldara, Efudex, and Fluoroplex are three of the most used drugs. Squamous cell carcinoma is generally not considered life threatening if treated early. However, if left untreated, squamous cell carcinoma can spread and it can then become life threatening. Reliable statistics are not available, however, because most of these cancers are treated in a dermatologist’s office.

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• Melanoma FAQs

  What Is Melanoma Skin Cancer? » Melanoma is the most dangerous type of skin cancer. It develops in the skin cells that produce melanin, the melanocytes. Exposure to ultraviolet radiation from the sun or from tanning beds increases a person’s risk of developing melanoma. The reason melanoma is more deadly than squamous cell or basal cell carcinoma is that as melanoma progresses it grows downward and can begin to deposit cancerous cells into the bloodstream where they can spread cancer anywhere in the body. What Causes Melanoma? The exact causes of melanoma are not fully understood, as it can occur in both people who have had serious sun exposure (in those areas) and in those who have not (when it occurs on areas such as the soles of the feet). It occurs when the DNA of the melanin-producing cells, the melanocytes, is damaged. This causes these skin cells to grow out of control, which can eventually become a mass of cancerous cells. It is believed that UV radiation is the leading cause. Melanoma is more common in those with fairer skin, as they have less melanin in the skin, which acts as a protection mechanism by darkening with sun exposure (tanning). It is thought that extreme peeling sunburns when a person is a child or adolescent have a direct correlation with an increased risk of melanoma. Research has shown that every one of these peeling sunburns can double the person’s risk of developing melanoma as an adult. What Are The Symptoms Of Melanoma? Melanoma can develop anywhere on the body, but in fair-skinned people, it usually develops in areas that have had lots of sun exposure: the face, arms, back, and legs. Unlike other skin cancers, melanoma can also develop in areas that don’t receive sun exposure, such as the soles of the feet, the beds of the fingernails, and the palms of the hands. This is rarer and occurs most often in people with darker skin tones. Melanoma is more common in people with over 50 moles on their body. The first signs and symptoms of melanoma are: A change in an existing mole Development of a new pigmented or unusual-looking growth on your skin or area of your skin This is not always the case, as melanoma can occur on skin that appears to be normal. When considering a mole to be melanoma, it helps to remember these ABCDE warning signs: Asymmetry — If one half of the mole doesn’t match the other half, that’s a concern. Normal moles are symmetrical. Border — If the border or edges of your mole are ragged, blurred, or irregular, it should be checked. Color — Normal moles are a single shade throughout. If your mole has changed color or if it has different shades of tan, brown, black, blue, white, or red, then it should be checked. Diameter — If a mole is larger than the eraser of a pencil, it needs to be checked. Evolving — If a mole evolves by shrinking, growing larger, changing color, itching or bleeding, or other changes, it should be checked. Melanoma lesions often grow in size or gain height rapidly. How Is Melanoma Treated? The treatment of melanoma depends on the size and stage of cancer. If caught early, melanoma can be fully removed during the biopsy. This is especially true if cancer has not started growing downward yet. There has been some success with early-stage melanoma using medications that make the body attack the area with white blood cells. Lotions are applied to the area with the melanoma and they inflame the area to a degree that the skin almost becomes an open sore. This inflammation activates the white blood cells to hunt for invaders, killing the cancer cells. Mohs surgery is effective for removing melanoma that has been diagnosed but hasn’t spread. Mohs surgery involves removing the melanoma and a surrounding ring of tissue. This outer ring is instantly examined under a microscope to see if there are cancer cells still present. If there are, another ring of tissue is immediately removed and examined. This process is repeated until the tissue is free of cancer cells. For Mohs surgery, you need to be sure to have a surgeon who is a member of the American Society for Mohs Surgery. These methods are used to remove melanoma that has not spread. If the melanoma has spread, treatment for this skin cancer is similar to treatment for other cancers: Surgery to remove the affected lymph nodes Chemotherapy Radiation therapy Immunotherapy What Is The Cure Rate For Melanoma? If caught early, the success rate for treating melanoma is very high. That’s why yearly skin cancer screenings are so important, particularly for people with fair skin. The estimated five-year survival rate for patients whose melanoma is detected early is about 99 percent in the U.S. But when cancer has spread to the lymph nodes, the five-year survival rate falls to 63 percent. If cancer has spread to distant organs, this rate falls to just 20 percent.

  Link: Melanoma FAQs

• Merkel Cell Carcinoma FAQs

  Merkel Cell Carcinoma Skin Cancer What Is Merkel Cell Carcinoma? » Also known as neuroendocrine carcinoma of the skin, Merkel cell carcinoma is a rare type of skin cancer. It occurs in the Merkel cells, which are found at the base of the epidermis, the skin’s outermost layer. It usually appears as flesh-colored or bluish-red nodules on the face, head, or neck. This form of skin cancer metastasizes quickly. It also has a high incidence of recurring. What Are The Symptoms Of Merkel Cell Carcinoma? » The first sign of Merkel cell carcinoma in most cases is a fast-growing bump on the skin. This is called a nodule, or tumor, and it can be either skin-colored or can be in shades of red, blue, or purple. They are most common in areas exposed to sun, but can develop elsewhere. What Causes Merkel Cell Carcinoma? » The causes of Merkel cell carcinoma are not fully understood. The Merkel cells are connected to the nerve endings in the skin that are responsible for the sense of touch. Recent research points to a common virus that likely plays a role in development of this rare skin cancer, the Merkel cell polyomavirus. This virus lives on the skin and doesn’t have any symptoms and is very common. It’s not clear why it sometimes may cause this rare skin cancer. These are thought to be the risk factors for Merkel cell carcinoma: Excessive UV exposure A weakened immune system History of other skin cancers Being over age 50 Light skin color How Is Merkel Cell Carcinoma Treated? » Excision is the first treatment option for Merkel cell carcinoma. The tumor along with a border of normal skin is removed. This may be done with a standard scalpel excision or it may be done with Mohs surgery to limit the amount of healthy tissue removed and manage future scarring. If the cancer has spread to the lymph nodes, they will be removed in what is called lymph node dissection. If the cancer has spread to other parts of the body, the treatments may include radiation therapy, immunotherapy, or chemotherapy. What Is The Cure Rate Of Merkel Cell Carcinoma? » As with melanoma, early diagnosis of Merkel cell carcinoma is imperative to increase the patient’s odds of successful treatment. The five-year survival rate for localized Merkel cell carcinoma, meaning it has not spread, is 78%. If the cancer has spread to the lymph nodes or other nearby structures, the five-year survival rate is 51%. If it has spread to distant organs or parts of the body, the five-year survival rate is just 17%

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• Actinic Keratosis FAQs

  What Is Actinic Keratosis? » Actinic keratosis is a pre-cancerous skin lesion on the skin. They are usually rough, scaly patches that form on the areas that receive extensive sun exposure: the face, lips, ears, backs of the hands, forearms, scalp, or neck. These growths develop slowly and don’t have any signs or symptoms other than their appearance. A small percentage of actinic keratoses can eventually become skin cancer. What Are The Symptoms Of Actinic Keratoses? » These growths are not painful and are not overly disfiguring because they remain small. These are the signs: Rough, scaly, dry patch of skin Usually less than 1 inch in diameter Flat to slightly raised patch or bump atop the skin Sometimes can be hard and wart-like Color may be pink, red, or brown May itch or burn when brushed What Causes Actinic Keratoses To Form? » Actinic keratoses develop as the skin’s response to frequent or intense exposure to ultraviolet radiation from the sun or tanning beds. There are certain risk factors that make a person more likely to develop an actinic keratosis: You are over age 40 Live in a sunny locale Have a history of sunburns Have red or blond hair Have blue or light-colored eyes Tend to freckle or burn when exposed to sunlight Have a personal history of actinic keratosis or skin cancer Have a weak immune system due to chemotherapy, AIDS, or other causes How Are Actinic Keratoses Treated? » Because actinic keratoses may develop into cancer, it’s a good idea to remove them as a precaution. Here are the typical methods: Medications These medications have been developed over the past decade or so. They cause the body to react and attack the abnormal actinic growths. These creams and gels cause inflammation and redness and then the actinic keratoses begin to crust and peel off. These are prescription drugs that are usually applied to the entire affected area: Fluorouracil cream Imiquimod cream Ingenol mebutate gel Diclofenac gel Surgical Removal Cryotherapy — Actinic keratoses can be removed by freezing the growth with liquid nitrogen. This causes the lesion to crust and peel off. This takes just a few minutes. Curettage — A small scoop-shaped blade, known as a curet, is used to scrape off the damaged cells. Using the curet may complete the procedure, or we may also use electrosurgery, where electric current destroys the affect tissue and closes off the blood vessels. Photodynamic Therapy — In this method, a light-sensitive chemical is first applied to the affected skin. Then a special light is directed onto the area. This destroys the actinic keratoses. What Is The Cure Rate For Actinic Keratosis? » Removing these growths before they become skin cancer is 100 percent successful. Other growths may develop, but they can be removed the same way. Schedule Your Actinic Keratosis Consultation Today! Interested in learning more about Actinic Keratosis? Give us a call at (714) 379-6262 or (800) 616-2767 to schedule your consultation today! We proudly serve those in Long Beach, California and nearby areas.

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• Atypical Fibroxanthoma FAQs

  What Is Atypical Fibroxanthoma? Atypical fibroxanthoma is a type of skin cancer that typically occurs on the head and neck of older people who have had lots of sun damage. It is not usually thought of with the more common skin cancers, such as basal or squamous cell carcinomas, but it is considered to be skin cancer. Atypical fibroxanthoma usually appear as pink-red raise areas or bumps that may be tender, and difficult to heal. It does not spread to other areas of the body. What Are The Symptoms Of Atypical Fibroxanthoma? Atypical fibroxanthoma can look like other non-melanoma skin cancers. These growths will show themselves as pink-red in color. They will be raised areas or individual bumps. These grow on the head and neck in older patients. What Causes Atypical Fibroxanthoma? Atypical fibroxanthoma is associated with prolonged years of sun exposure, aging, and possibly x-ray radiation exposure. Both UV radiation and x-ray radiation can cause abnormal growth of atypical spindle cells, which lead to these growths. How Is Atypical Fibroxanthoma Treated? These small growths are removed through surgical excision, either curettage or electrosurgery. Mohs micrographic surgery can be used for areas where a scar is undesirable, as it removes the least amount of healthy tissue. What Is The Cure Rate For Atypical Fibroxanthoma? Atypical fibroxanthoma rarely recur after complete excision with clear margins, making it virtually 100 percent cure rate. The key to not developing additional growths is to limit sun exposure to the areas of the head and back of the neck. Schedule Your Consultation Today! Interested in learning more about your available treatment options for Atypical Fibroxanthoma? Reach us at (714) 379-6262 or (800) 616-2767 to schedule your consultation today! American Society for Mohs Surgery serves Long Beach, CA and nearby areas.

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• Dermatofibrosarcoma Protuberans FAQs

  What Is Dermatofibrosarcoma Protuberans? » Dermatofibrosarcoma protuberans is a rare type of skin cancer that develops in the middle layer of the skin, the dermis. It grows slowly and seldom spreads. Treating it is important, however, as dermatofibrosarcoma protuberans can grow into surrounding fat, muscle, even bone. If that happens, it can be difficult to treat. What Are The Symptoms Of Dermatofibrosarcoma Protuberans? » The first sign of dermatofibrosarcoma protuberans is usually a small bump on the skin. The area of skin will feel rubbery or hard to the touch. This will be red and may resemble a deep-seated pimple. As it grows, it will turn into a reddish-brown and slightly raised patch of skin. By the time the red bump becomes the brown patch, the cancer is growing more rapidly and may cause pain or bleed. This only occurs in roughly 15 percent of people with dermatofibrosarcoma protuberans. What Causes Dermatofibrosarcoma Protuberans? » The causes of this rare form of skin cancer are unknown. There is some thought that dermatofibrosarcoma protuberans can begin on skin that was badly injured from a burn or from surgery. There is not a link between sun exposure and this rare skin cancer. How Is Dermatofibrosarcoma Protuberans Treated? » For many patients with dermatofibrosarcoma protuberans, Mohs surgery is recommended to remove the cancer. Because this form of cancer grows more deeply and tends to spread out akin to the roots of a plant, it can be harder to make sure all of the cancer is removed. By removing the main growth, along with a surrounding ring of healthy tissue, and then immediately examining the outer ring for cancer cells, Mohs surgery virtually assures success in removing all of the cancer. What Is The Cure Rate Of Dermatofibrosarcoma Protuberans? » Prior to the development of Mohs methods for excision, there was a high recurrence rate with dermatofibrosarcoma protuberans. That has changed. Even with recurrent dermatofibrosarcoma protuberans, Mohs surgery has a 98 percent cure rate. Schedule Your Dermatofibrosarcoma Protuberans Consultation Today! Interested in learning more about dermatofibrosarcoma protuberans? Call (714) 379-6262 or (800) 616-2767 to schedule your consultation today! Our practice serves Long Beach, California and nearby areas.

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