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Symptoms of Basal Cell and Squamous Cell Skin Cancers


A change on the skin is the most common sign of skin cancer. This may be a new growth, a sore that
doesn’t heal, or a change in an old growth. Not all skin cancers look the same. Usually, skin cancer is not painful.

Common symptoms of basal cell or squamous cell skin cancer include:

 Common symptoms of basal cell

A
A lump that is small, smooth, shiny, pale, or waxy

B
A lump that is firm and red

C
A sore or lump that bleeds or develops a crust or ascab

D
A flat red spot that is rough, dry, or scaly and may become itchy or tender

E
A red or brown patch that is rough and scaly

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Symptoms of Melanoma

Often the first sign of melanoma is a change in the shape, color, size, or feel of an existing mole. Melanoma may also appear as a new mole. Thinking of “ABCDE” can help you remember what to look for:

Asymmetry: The shape of one half does not match the other half.
• Border that is irregular: The edges are often ragged, notched, or blurred in outline. The pigment may spread into the surrounding skin.

Color that is uneven: Shades of black, brown, and tan may be present. Areas of white, gray, red, pink, or blue may also be seen.

Diameter: There is a change in size, usually an increase. Melanomas can be tiny, but most are larger than the size of a pea (larger than 6 millimeters or about 1/4 inch).

Evolving: The mole has changed over the past few weeks or months.

Melanomas can vary greatly in how they look. Many show all of the ABCDE features. However, some may show changes or abnormal areas in only one or two of the ABCDE features. In more advanced melanoma, the texture of the mole may change. The skin on the surface may break down and look scraped. It may become hard or lumpy. The surface may ooze or bleed. Sometimes the melanoma is itchy, tender, or painful.

Type A :
This photo shows an asymmetric melanoma with irregular and scalloped borders. The color varies from gray to brown to black. The melanoma is about 1.2 centimeters.

Type B :
This photo shows a dysplastic nevus with an arrow pointing to a new black bump that was not there 18 months earlier. The black bump is a melanoma that is about 3 millimeters.

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Risk Factors for Melanoma And Squamous Cell Cancer

Other Risk Factors for Melanoma The following risk factors increase the risk of melanoma:

• Dysplastic nevus: A dysplastic nevus is a type of mole that looks different from a common mole. A dysplastic nevus may be bigger than a common mole, and its color, surface, and border may be different. It’s usually wider than a pea and may be longer than a peanut. A dysplastic nevus can have a mixture of several colors, from pink to dark brown. Usually, it’s flat with a smooth, slightly scaly or pebbly surface, and it has an irregular edge that may fade into the surrounding skin. A dysplastic nevus is more likely than a common mole to turn into cancer. However, most do not change into melanoma. A doctor will remove a dysplastic nevus if it looks like it might have changed into melanoma.

• More than 50 common moles: Usually, a common mole is smaller than a pea, has an even color (pink, tan, or brown), and is round or oval with a smooth surface. Having many common moles increases the risk of developing melanoma.

Other Risk Factors for Both Basal Cell and Squamous Cell Skin Cancers The following risk factors increase the risk of basal cell and squamous cell skin cancers:
• Old scars, burns, ulcers, or areas of inflammation on the skin
• Exposure to arsenic at work
• Radiation therapy

Other Risk Factors for Squamous Cell Cancer

The risk of squamous cell skin cancer is increased by the following:
• Actinic keratosis: Actinic keratosis is a type of flat, scaly growth on the skin. It is most often found on areas exposed to the sun, especially the face and the backs of the hands. The growth may appear as a rough red or brown patch on the skin. It may also appear as cracking or peeling of the lower lip that does not heal. Without treatment, this scaly growth may turn into squamous cell skin cancer.

• HPV (human papillomavirus): Certain types of HPV can infect the skin and may increase the risk of squamous cell skin cancer. These HPVs are different from the HPV types that cause cervical cancer and other cancers in the female and male genital areas.

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Risks for Any Type of Skin Cancer Studies have shown that the following are risk
factors for the three most common types of skin cancer:

• Sunlight: Sunlight is a source of UV radiation. It’s the most important risk factor for any type of skin cancer. The sun’s rays cause skin damage that can lead to cancer.

-. Severe, blistering sunburns: People who have had at least one severe, blistering sunburn are at increased risk of skin cancer. Although people who burn easily are more likely to have had sunburns as a child, sunburns during adulthood also increase the risk of skin cancer.

-. Lifetime sun exposure: The total amount of sun exposure over a lifetime is a risk factor for skin cancer.

-. Tanning: Although a tan slightly lowers the risk of sunburn, even people who tan well without
sunburning have a higher risk of skin cancer because of more lifetime sun exposure. Sunlight can be reflected by sand, water, snow, ice, and pavement. The sun’s rays can get through clouds, windshields, windows, and light clothing.

In the United States, skin cancer is more common where the sun is strong. For example, more people
in Texas than Minnesota get skin cancer. Also, the sun is stronger at higher elevations, such as in the mountains. Doctors encourage people to limit their exposure to sunlight. See the Prevention section on page 36 for ways to protect your skin from the sun.

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Sunlamps and tanning booths: Artificial sources of UV radiation, such as sunlamps and tanning booths, can cause skin damage and skin cancer. Health care providers strongly encourage people, especially young people, to avoid using sunlamps and tanning booths. The risk of skin cancer is greatly increased by using sunlamps and tanning booths before age 30.

• Personal history: People who have had melanoma have an increased risk of developing other
melanomas. Also, people who have had basal cell or squamous cell skin cancer have an increased risk of developing another skin cancer of any type.

• Family history: Melanoma sometimes runs in families. Having two or more close relatives (mother, father, sister, brother, or child) who have had this disease is a risk factor for developing melanoma. Other types of skin cancer also sometimes run in families. Rarely, members of a family will have an inherited disorder, such as xeroderma pigmentosum or nevoid basal cell carcinoma syndrome, that makes the skin more sensitive to the sun and increases the risk of skin
cancer.

• Skin that burns easily: Having fair (pale) skin that burns in the sun easily, blue or gray eyes, red or blond hair, or many freckles increases the risk of skin cancer.

• Certain medical conditions or medicines: Medical conditions or medicines (such as some antibiotics, hormones, or antidepressants) that make your skin more sensitive to the sun increase the risk of skin cancer. Also, medical conditions or medicines that suppress the immune system increase the risk of skin cancer.

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Skin cancers are named for the type of cells that become malignant (cancer). The three most common
types are:

• Melanoma: Melanoma begins in melanocytes (pigment cells). Most melanocytes are in the skin. See the picture on page 4 of a melanocyte and other skin cells. Melanoma can occur on any skin surface. In men, it’s often found on the skin on the head, on the neck, or between the shoulders and the hips. In women, it’s often found on the skin on the lower legs or between the shoulders and the hips. Melanoma is rare in people with dark skin. When it does develop in people with dark skin, it’s usually found under the fingernails, under the toenails, on the palms of the hands, or on the soles of the feet.

• Basal cell skin cancer: Basal cell skin cancer begins in the basal cell layer of the skin. It usually occurs in places that have been in the sun. For example, the face is the most common place to find basal cell skin cancer. In people with fair skin, basal cell skin cancer is the most common type of skin cancer.

• Squamous cell skin cancer: Squamous cell skin cancer begins in squamous cells. In people with dark skin, squamous cell skin cancer is the most common type of skin cancer, and it’s usually found in places that are not in the sun, such as the legs or feet.  However, in people with fair skin, squamous cell skin cancer usually occurs on parts of the skin that have been in the sun, such as the head, face, ears, and neck.

Unlike moles, skin cancer can invade the normal tissue nearby. Also, skin cancer can spread throughout the body. Melanoma is more likely than other skin cancers to spread to other parts of the body. Squamous cell skin cancer sometimes spreads to other parts of the body, but basal cell skin cancer rarely does. When skin cancer cells do spread, they break away from the original growth and enter blood vessels or lymph vessels. The cancer cells may be found in nearby lymph nodes. The cancer cells can also spread to other tissues and attach there to form new tumors that may damage those tissues. The spread of cancer is called metastasis. See the Staging section on page 17 for information about skin cancer that has spread.