In our century, the number of cancer cases is gradually increasing, in consequence to the rapid development of the industry, pollution of the atmospheric air, i.e., the external environment, increased greenhouse gases, gradual impairment and thinning of the ozone layer and even loss of its some parts.
Today, half of the cancer cases consist of malignant skin tumors. In particular, basal cell skin cancers exhibiting a different biological structure constitute a large part of skin cancers.
All kinds of skin lesions that develop on the skin, grow, change color, itch, bleed or can be caught by comb and hand should be carefully dealt with.
The skin is the largest organ in our body. It protects the body from temperature extremes, sunlight, damages and infections. It also provides the control of body temperature and stores water, oil, and vitamin D. The skin consists of three layers. These are epidermis (outer or top layer), dermis (lower or inner layer), and subcutaneous adipose tissue (undermost layer), respectively (Figure 1).
The epidermis layer
It is the top layer of the skin, and contains three types of cells. Melanocytes are cells located at the undermost level of the epidermis, which produce the pigment called melanin that gives the skin its natural color. The melanocytes produce more pigments as the sun exposure increases, and consequently the skin gets darker.
The dermis layer
It is the layer located under the epidermis layer, and contains blood vessels, lymph vessels and glandular structures. It cools the body through the sweat glands located in it, besides other glands that produce sebum. Sebum protects the skin from dehydration. Sweat and sebum reach the small openings called pores on the skin surface.
Because the symptoms caused by cancer are visible on the skin surface, the rate of early diagnosis of this type of cancer is higher compared to other types of cancer.
How to Recognize Skin Cancers?
– They can be in the form of a white / pink colored small mass;
– A lesion with a smooth, bright or dimpled surface,
– A dry and scaly red dot,
– A crusty and lump-shaped red mass,
– Crusty small masses in juxtaposition,
– And a white patch that looks like a scar.
These kinds of lesions should be considered to be suspected cancer if they do not heal within 2 to 4 weeks, and if they bleed and cause pain.
Types of Skin Cancer
Basal Cell Skin Cancer
Basal cell skin cancer develops in consequence of the changes of basal cells in the epidermis (the top layer of that protects the skin against external effects), and it is the most common type of skin cancer. It progresses slowly, does not spread to the whole skin, and is rarely life threatening.
Among the symptoms of basal cell skin cancer, mostly pale red colored dry and scaly bulges are observed. Such bulges can turn into ulcer and their complete recovery may be impossible. These spots often appear in the areas of the skin, which are exposed to the sun, and they grow in the course of time.
Squamous Cell Skin Cancer
It is one of the common types of cancer. Because squamous cell skin cancer can spread to the lymph nodes and internal organs, the treatment should be started without delay. When not treated in time, squamous cell skin cancer may result in death.
The symptoms of squamous cell skin cancer include firm red spots on the skin, which easy bleed. The spots can also be dry and turn into ulcer. They are mostly seen in adults over 50 years of age.
Melanoma, the third and the most dangerous type of skin cancer, is rarely encountered compared to other types of skin cancer but may result in death when not diagnosed at an early stage. When not diagnosed early, it is possible to rehabilitate the patient. Moles with different colors and indistinct borders are likely to turn into melanoma.
The symptoms of melanoma may show themselves in the form of a new spot on the skin surface, or a change in the shape, color and size of an existing spot. They can also appear in the parts of the skin, which are not exposed to sunlight. Spots developing on the skin surface are mostly in the shape of a bulge or dome-like masses in “nodular melanoma”, another type of melanoma. After a while, bleeding and dryness can be observed in such bulges or dome-like masses. They are usually pink and red colored but can also be observed as brown and black.
Long time exposures to sunlight, getting sunburn without protection, genetic characteristics are some of the main causes of melanoma. In addition, the incidence rate of melanoma is higher in people with fair skin and lighter-colored eyes.
How to Diagnose the Skin Cancer?
For the diagnosis of benign and malignant tumors of the skin, first a skin tissue needs to be taken with an incisional or excisional biopsy, which is then required to be analyzed for a pathological-anatomical assessment, in order to have information about its structure.
By this way, very important findings are obtained in the selection of the surgical procedure to be carried, which varies depending on the boundaries of the tumor as well as the location and nature of the tissue to be removed. Of course, after removal of the tumor, the resultant cavity in the skin should be perfectly closed with free flaps, rotational flaps, and other suitable types of flaps and techniques; and eventually, a perfect skin aesthetic should be obtained.