Non-Melanoma Skin Cancer

Dermatology encompasses the everyday diagnosis, treatment, and prevention of skin cancers. Skin cancers can be broadly divided into two large groups: non-melanoma skin cancers and melanoma.

Non-melanoma skin cancers comprise basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).

Basal Cell Carcinoma

Basal cell carcinoma is the most common type of non-melanoma skin cancer and is caused by prolonged sun exposure. Its appearance is characterised as a pink raised nodular lesion. Spread to other organs is quite rare; however, in some cases it can develop into a wound that does not heal and forms crusts, which can eventually lead to destruction of underlying structures.

Squamous Cell Carcinoma

Squamous cell carcinoma is the second most common type of non-melanoma skin cancer and is also caused by prolonged sun exposure. Its appearance differs from BCC, presenting as a scaly non-healing patch, nodule, or plaque. Unlike BCC, squamous cell carcinoma can spread to other organs, and surgical treatment is therefore highly recommended.

Diagnosis

During an initial consultation, all changing moles and non-healing skin lesions are examined, as these are considered early signs of skin cancer. Dermatoscopy or epiluminescence microscopy is employed to magnify the assessed skin. In cases where suspicious characteristics are identified, a skin biopsy is taken to confirm the diagnosis.

Treatment Options

Following retrieval of biopsy results and confirmation of diagnosis, several treatment options may be considered:

• Surgical excision, including MOHS surgery
• Curettage and electrodesiccation
• Cryosurgery
• Topical chemotherapy
• Radiation therapy

Curettage and Electrodesiccation

The curettage and electrodesiccation method involves removal of basal cell carcinoma by scraping with a curette. The skin is then treated with electrosurgery to ensure that cancer cells have been completely removed.

Cryosurgery

Cryosurgery involves the destruction of cancerous cells using extremely cold temperatures and is used primarily for superficial types of non-melanoma skin cancer. Liquid nitrogen is the most common agent, with a boiling temperature of -196 degrees Celsius. The cold is applied to the affected skin area using an open spray, cryochamber, or specialised probe.