Skin Cancer: Types, Causes and Treatments

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  Skin is a phenomenal organ all over the body due to its massive size and functions. The integumentary systems’ functions are: to protect us from the external environment, excrete or sweat, blood reservoir, sensory reception, body temperature regulation, and metabolic functions. The integumentary system is made up from the epidermis, dermis, and hypodermis. The epidermis is composed of many distinct layers: the stratum corneum, stratum lucidum, stratum granulosum, stratum spinosum, and stratum basale. Stratum corneum is composed of many layers of dead keratinized stratified squamous cells that are nonvascularized, while stratum lucidum is only found in hands and feet. Stratum granulosum is involved with keratinization in the skin (1) while stratum spinosum is in charge of producing keratinocytes. The final layer of cells of the epidermis is the stratum basale that are the stem cells of the epidermis. The cells originate, form and slowly move up the layers as humans keep shedding off the dead cells in the stratum corneum. The basale layer is also where melanocytes are kept which produce skin pigmentation. The dermis is made up of  two layers that are called papillary and reticular. Unlike the epidermis, the  papillary layer is highly vascularized with areolar connective tissue being the main tissue. Inside meissner’s corpuscle is in charge of sensory reception, sebaceous glands, sweat glands, and free nerve endings as well. The reticular layer is composed of irregular dense connective tissue which is highly vascularized as well. The layer contains many veins and arteries. The final part of the of the skin and the deepest is called the  hypodermis, which is mainly composed of adipose tissue. Adipose tissue is used as a shock absorber, thermal insulators, and energy storer (1). The integumentary system protects beings from the inside and out. If there is a malfunction in the integumentary system there can be some fatal effects like skin cancer. Little bumps on the skin or moles can be a sign of cancer but one can detect skin cancer by using the ABCDE method. The ABCDE method is used by: asymmetry of the bump, border of the bump, variation of color of the bump, diameter of the bump (6mm) and evolving size. There are three types of skin cancer that can occur if the integumentary system is malfunctioning;  basal cell carcinoma, squamous cell carcinoma, and melanoma.

 Basal cell carcinoma is a type of skin cancer that is the most common among humanity and it originates from the basal keratinocytes from the epidermis. When the keratinocytes become cancerous they invade the dermis and the epidermis and changes the way normal skin looks into miniature tumors most common on the face. The causes for keratinocytes to become cancerous varies. UV damage to the skin, family genetics, frequent exposure to tanning beds, and severe sunburns as a child  are all causes of basal cell carcinoma (2). There are more than one type of BCC cancer; the most common being nodular BCC which are the most common types. Nodular BBC  appears as  tiny red bump that depresses in the center and this tumor will bleed continuously due to the notion that the blood vessels are crisscrossed (2). The second type of basal cell carcinoma is called morpheaform. These types are more difficult to detect due to the fact that these tumors are flat, and pale so they morph into the skin. Another BCC skin cancer called superficial basal cell carcinoma have tumors that look like a rash and can get confused with eczema or psoriasis. These tumors are found in the arms, legs and torso of the body as well (2). A general diagnosis for this skin cancer is a skin biopsy which is a very simple procedure where a removal of superficial tissue must take place. Once they have a skin sample, it is sent to a pathologist to be analyzed (2). Some treatments to remove the tumor and cancerous cells are surgical removal, laser therapy, radiation, and chemotherapy. It is highly important to return to the doctors regularly check for new cancerous keratinocyte cells because 36% of patients find new basal cell carcinoma cells back within five years (2).

 Squamous cell carcinoma is another type of skin cancer and is the second most common amongst humans. SCC  is known for strange cells from keratinized stratified squamous cells in the top layer of skin (3). Squamous cell carcinoma has the appearance of scaly red patches that may turn crusty and draw blood. If the SCC does not get any treatment, the results are life threatening because the cancer will spread and grow. Causes of squamous cell carcinoma is frequent exposure to UV rays, tanning beds, and injuries like scars. Women tend to get squamous cell carcinoma by being in tanning beds for a significant amount of time. Men around their fifties have more of an increased probability of developing SSC than females due to the notion that men spend more time in the sun (3.) SSC may occur on different regions of the physique , but are mostly found in areas where sunlight is exposed, such as the ears, lips, face, neck, scalp, arms, hands and legs. The integument in these regions are signs of destruction due to UV rays, including wrinkles, pigment changes, freckles, and loss of elasticity and broken blood vessels (3). A diagnosis for skin cancer will be a skin biopsy removing epidermal tissue to be sent to a pathologist. If the squamous cell carcinoma is found and treated early, there will be no issue removing the cancer. If one waits long enough, removing the tumor will be more dangerous due to the notion that the tumor is bigger in size. There are many types of treatment for squamous cell carcinoma like excisional surgery, laser surgery, radiation surgery, and cryosurgery (3).

 The most harmful skin cancer is melanoma. These skin tumors grow from DNA damaged melanocytes. Melanocytes helps produce pigmentation to the skin like moles and originate from the stratum basal layer of the skin. For the most case melanomas are black and brown but they can vary in color. The causes of melanoma is severe exposure to sunlight that leads to sunburn, moles, family history or a weakened immune system (4). There are four basic types of melanoma: superficial spreading melanoma, lentigo maligna, acral lentiginous melanoma, and nodular melanoma (4). Superficial spreading melanoma is the most known to individuals because many seem to have it. It grows all over the epidermis before penetrating deeper into the dermis. This type of melanoma grows all over the body in patches, and the borders are asymmetric with different variations of colors (4). Lentigo melanoma remains closer to the epidermis and appears as flat and slightly elevated tan or any dusky color. This type of skin cancer of melanoma is found more in older people due to UV ray exposure (4). Acral lentiginous melanoma also starts out with invading superficial skin before going to the dermis. This cancer is different from the other due to the fact that the tumors are more black in the palms and soles of feet. Acral lentiginous is developed  mostly in tan people and caucasians are less likely to develop this type of melanoma (4). Nodular melanoma is quite harmful because NM is already invasive when it is diagnosed (4). The location where this type of melanoma originates are arms, legs, and trunk. Melanoma can be curable if treated quickly. However, if too late the cancer will spread and it will be nearly impossible to cure. The first step of treatment is to remove the melanoma tumor surgically because melanoma is immune to chemotherapy (4). Once the tumor is removed, it is crucial that one returns to the doctors to see if new cancerous melanocytes are still alive.

The integument  is a very useful organ that safeguard individuals from the outside. If there is a malfunction to the system, the individual are put at serious risks to get skin cancer. The different types of skin cancers are basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal cell carcinoma is highly common among individuals and has three different types: nodular, morpheaform, and superficial basal cell. Basal cell carcinoma is caused by cancerous keratinocytes but can be treated with surgery. Squamous cell carcinoma is also common but not as profound as BCC. SSC looks like scaly pink patches on the external ears and scalp. This type of cancer is caused by abnormal stratified squamous cells and can be treated by radiation and surgery. Melanoma is the final kind of skin cancer, which is also the most troublesome. It is caused by cancerous melanocytes invading the epidermis. The outcome to having this dangerous skin cancer is black or different color blotches/ bumps on the skin that get often confused as moles. There are four types of melanoma: superficial, lentigo, acral lentiginous, and nodular. Melanoma is resistant to chemotherapy therefore it is only treated by surgery. All three skin cancers are caused by frequent vulnerability to sunlight. In order to prevent all of these skin cancer use sunscreen and stay away from too much UV rays. Not only should individuals stay away from the sun, but tanning beds as well. Too much tanning can lead to skin cancer.

Citation Page

  1. Mc Lafferty, E. (2012). The integumentary system: Anatomy, physiology and function of skin. Nurs Stand.https://www.ncbi.nlm.nih.gov/pubmed/23248884
  2. Feller, L., Khammissa, R. A., Kramer, B., Altini, M., & Lemmer, J. (2016, February 05). Basal cell carcinoma, squamous cell carcinoma and melanoma of the head and face. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4744388/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4744388/
  3. Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. (n.d.). Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/rr58e324a1.htm  https://www.cdc.gov/mmwr/preview/mmwrhtml/rr58e324a1.htm
  4. Skin Cancer Foundation. (n.d.). Retrieved from https://www.skincancer.org/skin-cancer-information/melanoma

 

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