Nodular basal cell carcinoma
Melanoma
Cutaneous squamous cell carcinoma
The “Big 3”:
- Basal cell carcinoma – the most common cancer diagnosed in the United States
- Squamous cell carcinoma – the second most common cancer worldwide
- Melanoma – the deadliest skin cancer
Merkel cell carcinoma
Dermatofibrosarcoma protuberans
Cutaneous T-cell lymphoma
Others, including
- Merkel cell carcinoma – favors older adults
- Cutaneous T-cell lymphoma – eg, mycosis fungoides, Sézary syndrome
- Dermatofibrosarcoma protuberans – rare; may be confused with a keloid
Skin exam: Incorporate into the physical exam
- Get in the habit of having patients remove their clothes and put on a gown.
- Look at their skin during every type of exam (eg, during a lung or cardiac exam, look at spots on the back while you’re auscultating).
- If possible, look at both sides of the hands and feet as well as nails.
Red flags
- A “pimple” that won’t go away
- Nodules that are affixed to the skin (vs. moveable under the skin)
- Anything that bleeds on its own
- Chronic ulceration
- Lesions changing in color, symptoms, etc
Education: Patients may not be aware!
- Stay out of the sun when it is the strongest (between 10:00 AM and 3:00 PM).
- Wear broad-spectrum sunscreen with sun protection factor (SPF) 30 or higher.
- Wide-brimmed hats, sunglasses, long-sleeved shirts, and umbrellas can help avoid some sun exposure.
Explain the ABCDE(F)s to help with early self-detection:
- Asymmetry of pigmented lesions
- irregularity of Borders
- change or variegation of Color
- large Diameter (greater than 6 mm)
- Evolution
*F = Funny looking or “freaky”
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