When the certified dermatologist Dr. Elizabeth Tanzi While she was pregnant with her first child, a dark spot formed on her leg. Six months later, when the spot began to grow, alarm bells began to ring.
“As a dermatologist, I knew that any change in a mole could indicate cancer, so I did a biopsy and it turned out to be melanoma,” she said. “I was 37 at the time and extremely worried, but the surgeon was able to remove it completely.”
Skin cancer is one of the most common forms of cancer, with more than 9,000 Americans This disease is diagnosed every day. Healthy sun protection practices, monthly self-exams, and knowing the basics of skin cancer (asymmetry, border, color, diameter, and progression) are always good ideas, but dermatologists warn there are other things to consider that may surprise people.
Although reggae pioneer Bob Marley died of melanoma that began under his toenail, nails remain an area where cancer often goes unnoticed.
“We most commonly see squamous cell carcinoma and melanoma under the nail,” explains Dr. Jennifer Holmana board certified dermatologist with Tyler American Dermatological Partners“Squamous cell carcinoma looks a lot like a wart under the nail, while melanoma presents as new, irregular or changing pigment streaks along the nail and cuticle.”
The problem with this spot is that it looks a lot like a bleeding wart, bruise or fungal infection, and many people don’t realize it could be something more serious. Because of this, cancer that forms under the nail can have a very poor prognosis, Tanzi said.
Holman, who was diagnosed with melanoma after noticing a changing mole on her stomach, attributes her diagnosis to her heavy use of indoor tanning in college.
“We know that even a single exposure to indoor tanning can exponentially increase the risk of melanoma, and that women under 30 are six times more likely to develop it. develop early onset melanoma “if they use artificial tanning,” Holman said.
The reason? Indoor tanning typically involves concentrated UVA radiation, which specifically increases the risk of melanoma, according to Holman.
“We generally think of UVB as the rays that cause sunburn, but UVA penetrates deeper and increases that risk,” she said. “The incidence of skin cancer is higher than that of any other malignant disease in humans, yet one of its root causes (ultraviolet radiation) is perhaps better understood than any other human carcinogen.”
Although rare, skin cancer between the toes is a possibility, and a dangerous one at that.
“Melanoma, when caught early, has a very good cure rate. However, when it progresses and spreads into the skin, it can be deadly,” Tanzi said. “Because people don’t always notice a change in moles between their toes or on the sole of their foot, melanoma in these areas is particularly dangerous because it goes unnoticed for long periods of time and can spread.”
According to the American Academy of Dermatology, about half of all melanomas are self-diagnosed —so if you notice a concerning spot, have it checked by a board-certified dermatologist.
The most common forms of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma. While the first two types are associated with sun exposure, melanoma can occur in some circumstances even without sun.
“I hear patients describe basal cell and squamous cell carcinomas as areas that bleed more easily,” Holman said. “Usually, patients think they have a pimple, an inflamed hair follicle or a bug bite when it forms, but it doesn’t heal and continues to grow and bleed.”
Remember that skin lesions that bleed or do not heal over time are never normal and can be a warning sign of possible skin cancer.
While dermatologists typically use the ABCDE rules to assess changes in your skin — the spots that become Asymmetrichave an irregularity Bordernew or changing ColorsA Diameter larger than a pencil eraser, or appears to be Evolution — it is not true of all melanomas, Holman said.
“Sometimes they don’t even have any pigment at all. The main thing to look for is any spot, even if you don’t know how long it’s been there, that changes or doesn’t heal after a few weeks.”
Early diagnosis is crucial both for the aesthetics of the scar left and for the overall survival rate of the patient.
Especially in the early stages, skin cancer can resemble benign skin conditions such as eczema or psoriasis. Unfortunately, this similarity can lead to misdiagnosis or late diagnosis.
“Some patients come to me thinking they have a plaque of eczema or psoriasis, but it may actually be a superficial basal cell or scaly plaque,” Holman said. “Both psoriasis and eczema (atopic dermatitis) can present as red, scaly spotsbut if an area does not respond to traditional treatments or does not heal or disappear after a few weeks, it should be evaluated by a board-certified dermatologist.
Although people with lighter skin are more likely to develop skin cancer, people of all skin colors are at risk for skin cancer, even those with darker skin.
Holman, who recently performed melanoma excision surgery on a woman with the darkest skin type, said that unfortunately, melanoma is less suspected and therefore often detected later in darker skin types.
“The same number of Caucasians and African Americans develop melanoma on the feet, while Asians and African Americans most commonly develop melanoma on the hands and feet,” Holman said. “That’s why the morbidity and mortality rate of melanoma is higher in darker skin tones, because melanoma on the soles of the feet, between the toes and under the nails is often detected at a later stage and therefore may carry a higher risk.”
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