Introduction
Non-melanoma skin cancer refers to all the forms of skin cancer that are not skin cancer of melanocytes. A broad number of non-melanoma skin cancers are present. The most common types of non-melanoma skin cancer are discussed below. Treatment of non-melanoma skin cancer varies for all kinds of cancer. Skin cancer treatment usually involves surgery to remove the cancer cells.
What Are the Types of Non-melanoma Skin Cancer?
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Basal cell carcinoma.
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Squamous cell carcinoma of the skin.
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Angiosarcoma.
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Cutaneous B - cell lymphoma.
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Cutaneous T - cell lymphoma.
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Dermatofibrosarcoma protuberans.
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Merkel cell carcinoma.
Basal Cell Carcinoma:
Basal cell carcinoma develops in basal cells, which produce new skin cells. Basal cell carcinoma develops on sun-exposed body parts, particularly the head and neck. These are glossy, translucent, skin-colored bumps that bleed and form a filmy layer. Basal cell carcinoma develops when DNA mutation occurs in one of the basal skin cells. The accumulating abnormal basal cells triggered by the DNA form a cancerous tumor. Sun's ultraviolet rays, tanning lamps, and beds also damage the DNA of the basal cells.
Squamous Cell Carcinoma:
Squamous cell carcinoma of the skin is a common skin cancer that occurs in the squamous cells present in the middle and outer skin surfaces. Although squamous cell carcinoma of the skin is aggressive, it is not life-threatening. However, when left untreated, squamous cell carcinoma of the skin spreads to other body parts, causing severe complications. Squamous cell carcinoma of the skin is red, firm, rough, scaly patch or nodule, sometimes wart-like sore commonly occurring on the scalp, back of the hands, ears, or lips. Squamous cell carcinoma of the skin develops when the DNA mutation occurs in the squamous cells in the middle and outer layers of the skin. The sun's ultraviolet radiation triggers the DNA mutation.
Angiosarcoma:
Angiosarcoma is a rare form of cancer that develops in the blood and lymph vessels lining. Angiosarcoma of the skin occurs commonly in the scalp, skin on the head, and neck. These are raised, bruise-like growth that bleeds on scratching. The surrounding area swells up. When angiosarcoma involves organs, it causes pain. It may occur when a cell mutation is lining the blood or lymph vessel. This results in overgrowth of the abnormal cells in the blood or lymph vessels. Over time, cells break down and spread to other parts of the body.
Cutaneous B - Cell Lymphoma:
Cutaneous B-cell lymphoma is a rare white blood cell cancer involving the B-lymphocytes.
The types of cutaneous B-cell lymphoma are:
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Primary cutaneous follicle center lymphoma.
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Primary cutaneous diffuse large B-cell lymphoma.
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Primary cutaneous marginal zone B-cell lymphoma.
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Intravascular diffuse large B-cell lymphoma.
Cutaneous B-cell lymphoma appears as a nodule below the skin-colored skin, pink or purple.
Cutaneous T - Cell Lymphoma:
Cutaneous T-cell lymphoma (CTCL) is a rare cancer of white blood cells, T lymphocytes. These are the immune cell systems. In cutaneous T-cell lymphoma, the T cells develop defects, attacking the skin. Cutaneous T-cell lymphoma is a type of lymphoma called non-hodgkin's lymphoma. Cutaneous T-cell lymphoma appears as round, raised, scaly skin patches that may be itchy. It is characterized by enlarged lymph nodes, hair loss, skin thickening on the palms and soles.
Dermatofibrosarcoma Protuberans:
Dermatofibrosarcoma protuberans (DFSP) is a sporadic skin cancer of connective tissue cells in the skin's dermis. Dermatofibrosarcoma protuberans begin as a bruise or scar. As it grows, lumps of tissue (protuberans) may form near the skin's surface. This skin cancer often starts on the arms, legs, and trunk. Dermatofibrosarcoma protuberans grow slowly and rarely spread beyond the skin.
Merkel Cell Carcinoma:
Merkel cell carcinoma is a rare skin cancer, usually bluish-red nodule, on the face, head, or neck. Merkel cell carcinoma is also known as neuroendocrine carcinoma of the skin. The earliest sign of merkel cell carcinoma is a fast-growing, painless, red, blue, or purple nodule on the skin. Most areas of merkel cell carcinomas are the face, head, or neck but can develop in any body part.
Merkel cell carcinoma develops in the merkel cells. Merkel cells are present at the base of the outermost layer of the skin that connects to the nerve endings and perceives the touch sensation. Research shows that merkel cell polyomavirus residing asymptomatic on the skin can develop into cancer.
Sebaceous Carcinoma:
Sebaceous carcinoma is a rare cancer that originates in an oil secreting gland in the skin. Sebaceous carcinoma affects the eyelids. Sebaceous carcinoma may start as a painless lump or skin thickening on the eyelid. As it matures, cancer bleeds or oozes. Finally, sebaceous carcinoma appears as a yellowish bleeding lump.
How Is Non-melanoma Skin Cancer Diagnosed?
A thorough physical examination can diagnose non-melanoma skin cancer along with complete blood count with differential blood count, skin biopsy (punch biopsy, excisional biopsy), bone marrow biopsy (specific to cutaneous T-cell lymphoma), eye examination (specific to sebaceous carcinoma), imaging tests like CT, MRI, and positron emission tomography (PET) scan.
How Is Non-melanoma Skin Cancer Treated?
Treatment of non-melanoma cancer includes:
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Surgically remove the lesion with some adjacent healthy tissues.
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Curettage and electrodesiccation (C and E) can be done.
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High-energy radiation therapy like X-rays and protons can be suggested.
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Chemotherapy, immunotherapy, interferon therapy may be prescribed.
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Cryosurgery is the freezing of abnormal tissues under extremely low temperatures.
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Corticosteroids topical creams or ointments are given to promote healing and control infection.
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Phototherapy photodynamic therapy can precisely target the lesion.
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Extracorporeal photopheresis may be suggested.
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Bone marrow transplant is specified to cutaneous – T cell lymphoma.
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Imatinib-loaded targeted therapy is specified for dermatofibrosarcoma protuberans.
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Lymph node dissection occurs when the lesion spreads to the adjacent lymph node.
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Laser therapy.
How Is Non-melanoma Skin Cancer Prevented?
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Avoid artificial or natural sunlight and stay indoors during the middle of the day.
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Apply an ample amount of sunscreen lotions every two hours.
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Cover skin with dark tightened clothing, ultraviolet (UV) light protected sunglasses.
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Avoid using tanning beds.
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Go for regular skin checkups. If any changes or abnormalities are seen, consult a dermatologist.
Conclusion
Non-melanoma skin cancers are a widespread group of malignancies. The commonest malignancy is basal cell carcinoma and squamous cell carcinomas; yet, it is the least aggressive and best managed. Although these non-melanoma share several characteristics, they differ from etiology to progression. One common characteristic among these is solar or artificial ultraviolet radiation. Therefore, improving awareness of skin cancer progression will help prevent, screen, diagnose the cancer at the earliest stages.
