Melanoma | Dr. Forley
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Posts Tagged ‘melanoma’


Friday, July 5th, 2013



Preventive measures can reduce the chances that you will be one of the 20% of Americans who will develop skin cancer in their lifetime. Although being diligent about taking precautions can be challenging, reducing your exposure to sun beginning at a young age is the single most important step you can take. UVA and UVB radiation causes damage to the DNA of skin cells which results in genetic changes that can produce skin cancer.



Here are some methods to protect yourself from the primary cause of skin cancer, UVA and UVB exposure:

Sunscreen: Physical sunscreens like eltaMD  provide long lasting UVA & UVB protection by utilizing microfine, transparent zinc oxide. Daily use is advised as your skin is subject to the effects of UV rays even on cloudy days in winter.

Limit direct sun exposure –  UV rays are strongest when the sun is high in the sky, usually between the hours of 10am and 4pm. Try to schedule activities to avoid being outdoors for too long during these peak hours.

Cover up – Use protective clothing when you are in the sun at the peak exposure hours. Specialized fabrics by companies like SunDayAfternoons, provide UV-rated protection for your skin.

elta MD skin careWear a hat

Wear a hat – A 2- to 3-inch brim all around will protect areas such as the ears, eyes, forehead, nose, and scalp that are often exposed to intense sun. These are known high risk areas for the development of skin cancer.

Wear sunglasses – UV-blocking sunglasses are important for protecting the delicate skin around the eyes, as well as the eyes themselves. Your chance of developing eye disease is increased by long hours in the sun without protection. 

Avoid tanning beds – The cumulative effect of exposure to the ultraviolet rays used in tanning beds can increase the risk of developing melanoma by as much as 75% when tanning is started before age 35.


If you take the time to become familiar with your skin, you will be able to more easily  identify any changes that occur at an early stage. Many skin cancers can be detected when they first start if the skin is monitored on a regular basis. A self-exam is best done with good lighting and a full-length mirror. You should learn the appearance and pattern of any moles, blemishes, freckles, or other marks on your skin so that any changes will be apparent to you the next time you do a body check. Any area that concerns you should be brought to the attention of your physician. You should also ask your physician if your specific skin type and risk factors warrants an annual body check by a dermatologist.

If skin cancer is suspected, a skin biopsy will usually be performed. An excisional procedure may be all that is needed. A specialized technique called Mohs surgery may be used to examine the tissue at the time of the excision. This enables the removal of all cancer cells while sparing as much uninvolved tissue adjacent to the cancer as possible. Reconstruction is performed to minimize any cosmetic defects as a result of the cancer treatment. For cancers such as melanoma that might be more extensive, tests to determine any spreading of the cancer may be recommended. Chemotherapy, immunotherapy, radiation, or additional surgery might be needed if other organ systems are affected.

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Monday, June 24th, 2013

More than 3.5 million skin cancers are diagnosed each year in the United States, making it the most prevalent of all cancers. It is more common than cancer of the breast, prostate, lung, and colon combined. It is estimated that 20% of Americans will develop skin cancer in their lifetime. Although it is very widespread, there is some good news:


  • Since most skin cancers are caused by excessive sun exposure, prevention measures can significantly reduce your risk of getting skin cancer
  • Awareness of skin cancer warning signs enables treatment at an early stage thereby minimizing the risk of spreading or recurrence




Basal and squamous cell cancers (keratinocyte cancers) are the most common forms of skin cancer. They are found mainly on parts of the body exposed to the sun, such as the head and neck. These cancers rarely spread elsewhere in the body and are much less likely than melanomas to be life threatening. Although they grow very slowly, both of these types of skin cancer can become quite large and affect nearby tissues. Scarring, disfigurement, or even functional loss may be the outcome if they are ignored or left untreated.

Basal Cell Carcinoma

Squamous Cell Carcinoma

Squamous Cell Carcinoma

Basal Cell Carcinoma








Melanomas can occur anywhere on the body but certain locations are at higher risk. Women are most commonly affected on the legs, neck, and face while the chest and back have the highest incidence in men. Melanomas can be much more invasive than basal cell and squamous cell cancers, but are almost always curable in their early stages. Disability and death can result if melanoma spreads to other parts of the body.




Basal cell carcinomas have a range of appearances. They may appear flat, firm, and pale in color but can develop as a small, raised, pink or red growth on your skin. A characteristic translucent, shiny, or waxy surface may be evident. They also may be prone to bleed after a minor injury. Multiple small blood vessels may be apparent on the surface. Sometimes the central portion of the lesion may have a crater-like depression and blue, brown, or black areas may be present. Large basal cell carcinomas may have oozing or crusted areas.

Squamous cell carcinomas typically look like lumps that will gradually increase in size if left untreated. The surface is usually rough, scaly, and crusted. These carcinomas may also appear as flat red patches that grow very slowly.

Melanomas are flat or raised pigmented areas on the skin that appear to change in size, shape, or color over time. They also frequently look different from moles or skin pigmentation present elsewhere on your body.

The ABCD rule is a guide for any signs of change in a pigmented skin lesion that should immediately be brought to the attention of your doctor:

(A) Asymmetry – meaning each half of the skin lesion or growth appears different

(B) Border irregularity – meaning the edge of the lesion is uneven

(C) Color irregularity – meaning the color of the lesion is not uniform and may have several different shades

(D) Diameter – meaning the diameter is relatively large (over 5 mm)

The ABCD rule does not apply in every case, so it is important to be aware of any changes that occur in skin lesions that have been present for a long time. In addition, new skin lesions or lesions that look different from the rest of your moles need to be carefully monitored.

An annual body check by a physician is especially important if you have a history of extensive sun exposure. Any lesions that develop ulcerations and are eroding or enlarging need to be evaluated.

In the next blog, prevention and treatment of skin cancers will be discussed.


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