Skin Cancer

All of the dermatologists at Dermatology Associates, PA are well trained in the diagnosis and treatment of skin cancers. We perform all surgical treatments in our well-equipped surgical suites. Here are some examples:

Basal Cell Carcinoma (BCC)

Basal Cell Carcinoma (BCC) is the most common malignancy in humans. It usually occurs on sun-exposed skin in patients with a history of chronic sun exposure. These skin cancers are typically slow-growing and rarely spread to other areas of the body. If neglected, BCC can be locally invasive and disfiguring.

BCC usually presents as a non-healing waxy sore with a pearly appearance. Bleeding and erosion are fairly common, as are fine blood vessels (telangiectasia) on the surface of the lesion.

Treatment usually consists of surgical removal in our office. Most lesions are treated with simple surgical excision. Mohs surgery is an advanced technique used at Dermatology Associates, PA for the microscopically controlled removal of aggressive or difficult lesions. Topical immunotherapy with Imiquimod (Aldara) can be used for superficial lesions.

Squamous Cell Carcinoma (SCC)

Squamous Cell Carcinoma (SCC) of the skin is the second most common form of skin cancer. SCC is much more common in areas with a high level of sun exposure. The primary cause is cumulative lifetime sun exposure Aggressive forms of SCC can metastasize (spread) to other areas of the body.

Most SCC arise from pre-cancerous lesions called actinic keratoses. these lesions are common on sun-exposed skin in fair skinned individuals. Treatment of actinic keratoses with liquid nitrogen can prevent progression to SCC.

SCC usually presents as a non-healing crusty patch or nodule that is painful. Most lesions arise in sun-exposed skin.

Treatment consists of surgical removal in most cases. Nearly all cases can be treated in the office.

Malignant Melanoma

Malignant Melanoma is the least common of skin cancers, but the most feared because of its potential to spread to other areas of the body. melanoma accounts for only 4% of all skin cancers; however, it causes the greatest number of deaths from skin cancer.

Melanoma can arise from a pre-existing mole, or can arise on normal appearing skin. Intense, intermittent sun exposure has been linked to the development of melanoma. Fair complexion, a history of blistering sunburns, a family history of melanoma and a large number of moles are other risk factors for melanoma. The current lifetime risk for developing melanoma is a startling one case per 65 Americans and this number continues to rise.

It is important to recongnize the early warning signs of melanoma. One successful method is the use of the ABCDE criteria:

A = Asymmetry ( one half does not match the other half)
B = Border irregularity ( the edges are jagged)
C = Color variegation (multiple colors within the lesion)
D = Diameter (although melanomas can be smaller, a diameter of greater that 6mm is typical)
E = Evolving (changes occuring over time)

The most common early symptom of melanoma is itching.

Melanoma is easily cured by surgical exision if it is detected early, before it has had a chance to metastasize. Prognosis is closely related to the microscopic thickness of the melanoma at the time that it is removed. Melanomas that have spread to other body areas remain very difficult to treat.

Mohs Surgery

Mohs micrographic surgery is an outpatient form of skin cancer removal that is used for more aggressive or difficult to treat lesions. This form of surgery provides a very high cure rate.

The greatest advantage of Mohs surgery is that the entire margin or area around the skin cancer is evaluated microscopically at the time of removal. This method allows for precise removal of the skin cancer while preserving the greatest amount of normal skin.

When arriving for Mohs surgery, the patient will be taken to our Mohs operating suite. After local anesthetic is administered, a layer of tissue around the cancer is removed and specially prepared for microscopic evaluation. The patient is then bandaged while the specimen is processed. This is part of the procedure usually takes from 30-90 minutes, depending on the size of the lesion. The Mohs surgeon will then evaluate all of the Margins of the skin cancer. If tumor is still present at a tissue edge, that area is mapped out and only that area is reexcised. When the Mohs surgeon determines that all of the skin cancer has been removed, reconstruction options will be discussed.

The dermatologists at Dermatology Associates, P.A. will be glad to discuss the various treatment options for skin cancer removal. Mohs surgery is not indicated for all skin cancers, but it is an important and valuable service that we are pleased to provide when needed.