Dermatology Series: Skin Tumors & Skin Cancer

The word “tumor” for obvious reasons sets off all sorts of alarms and raises an immediate red flag in one’s mind. Now tumors can be either benign (harmless on their own) or malignant (deadly with passing time). It just so happens that there are several benign tumors of the skin as well as a few malignant ones. But for the sake of simplicity it’s best to categorize skin related masses as vascular tumors & cancer.

Vascular Skin Tumors

Kaposi Sarcoma

Fairly common in AIDS patients (after the HIV has damaged the immune system sufficiently), they're raised & dark spots that cover a segment of the patient's skin. Kaposi can affect other body regions such as the mouth as well. 

Cherry Hemangioma

As the name suggests it looks quite like a cherry. These are benign and are simply associated with being old. Unfortunately, they do not get better.

Angiosarcoma

This is actually a cancer of blood vessels and they tend to occur in areas exposed to the sun (surprise!), particularly the head & neck. The prognosis for angiosarcoma is quite poor.

Strawberry Hemangioma

They look like a larger version of cherry hemangiomas. In contrast, they occur in infants and suddenly get better after a few years. As you would guess, they are benign.

Glomus Tumor

A reddish blue mass that occurs under the fingernails generally. The good news is that they are benign. The bad news… they’re painful.

Skin Cancer

Melanoma

Starting off with the most well-known and deadliest skin cancer out there: melanoma. Like the other two major skin cancers, it is strongly associated with sunlight exposure. What differentiates melanoma from the others is the ability to penetrate deep into the skin and spread throughout the body. There are 5 key things to remember for detecting melanoma early and improving prognosis. They’re known as the ABCDEs: Asymmetry / Border irregularity / Color differences within the mass / Diameter over 6mm / Change over time. In simpler terms, any mole or skin discoloration/mass that begins changing in size, shape or color should be immediately seen by a physician.

Basal Cell Carcinoma

This is actually the most common skin cancer. Once again, skin regions exposed to sunlight are at high risk. Basal cell carcinoma typically looks like a large and rough ulcer that does not improve. The fortunate thing about them is that they usually do not spread and remain invasive within that specific skin region.

Squamous Cell Carcinoma

Again, sunlight exposure is the biggest risk as they are commonly found on the hands or face. Like basal cell carcinoma, they usually do not spread throughout the body and hence have a good prognosis. As mentioned in a previous article, actinic keratosis is a precursor lesion to squamous cell carcinoma and it arises due to prolonged sun exposure.

Other skin cancers which are rare: Dermatofibrosarcoma Protuberans & Merkel Cell Carcinoma

Once again, sun exposure has been a key theme in the dermatology series. However, it is important to remember that skin cancers aren’t always the result of sunlight. Other things like arsenic or vitamin D deficiency also elevate one’s risk. And sometimes cancer develops in the absence of any risk factors. The key lesson is to apply that sunscreen & avoid sunlight; but also remember to keep an eye on your skin for abnormalities even if you never go out in the sun and supplement your vitamin D instead.