Carcinoma

Cutaneous carcinoma is also called non-melanocytic cancer and develops in cells of the epidermis, unlike melanoma which affects pigment cells or melanocytes .

We speak of basal cell carcinoma when the cancer develops in the basal cells (which are found in the deepest layer of the epidermis), and of squamous cell carcinoma if the superficial cells are concerned.

Areas exposed to the sun, such as the face, arms and décolleté, are the most affected by carcinomas. Those at risk are most likely to develop carcinoma, so it is important to look for precancerous lesions such as actinic keratoses .

Basal cell carcinoma

Basal cell carcinoma is the most common skin carcinoma . It is not life-threatening and does not give distant metastases. This type of skin cancer is mainly linked to sun exposure and also occurs on surfaces exposed to the sun: head, face , neck , or trunk. Its evolution is slow and makes its screening easier. A basal cell carcinoma can present in different forms:

• The nodular form is the most frequent: the appearance of a nodule or lump of pink color and firm consistency, particularly on healthy skin
• A wound that does not heal or reappears after healing
• The appearance or change of a skin growth
• Flat yellow or white areas that look like scars .
• Red, scaly patches

Squamous cell carcinoma

Squamous cell carcinoma develops from keratinocytes , the cells in the surface layer of the epidermis. If it can appear on healthy skin, squamous cell carcinoma is also likely to arise on scarred skin, burns , wounds or areas treated with radiotherapy.

Certain skin manifestations should alert you to the risk of squamous cell carcinoma:

• A pimple that looks like a wart
• A sore that does not heal and forms scabs
• A scaly-looking mass with irregular edges

An annual visit to your dermatologist is an opportunity to carry out a dermatological check-up, especially in individuals at risk.

It is important to consult a dermatologist quickly in the following cases:

• Any pre-existing skin lesion that is rapidly changing
• A wound that takes a long time to heal
• The appearance of a new skin lump

Exposure to ultraviolet rays is the main risk factor for skin carcinoma: the sun and artificial tanning booths are sources of UV rays.

• Phototypes I and II
• Personal history of skin cancer
• A history of radiation therapy
• Occupational exposure to arsenic
• Low immunity

The treatment of skin carcinoma is part of the dermatological surgery performed by our team of dermatologists at Skin Marceau.

Following a targeted questioning and the search for family history, a clinical examination supplemented by a dermoscopy is carried out. In severe cases, referral to hospital care may be indicated.

Excision of the carcinoma is possible under local anesthesia. An anatomopathologic analysis follows the biopsy and determines the type of skin carcinoma.

If the skin tumor has not been completely removed, different surgical techniques may be considered by your dermatologist. This will be decided based on the size and location of the carcinoma. The surgery has two main objectives: to reduce the risk of recurrence by completely removing the tumor and healthy surrounding tissue, and to reconstruct the operated area.

To ensure removal of the entire carcinoma, the excision performed is larger than the size of the visible lesion. An additional safety margin is recommended.

After surgery, it is recommended to do an annual clinical follow-up with your dermatologist, as well as to practice self-monitoring and appropriate sun protection.

Removal of a small carcinoma usually leaves an inconspicuous and cosmetically moderately visible scar . However, when the tumor is large or has spread to underlying tissue, it is sometimes necessary to remove a large volume of skin tissue. In this case, a simple suture of the skin is not enough to close the wound. Depending on the size of the area to be filled, different techniques to repair the affected area may be considered.