Skin Cancer in Children: Symptoms, Risk Factors, and Treatment

Introduction

The most prevalent type of cancer in people is skin cancer. Only 2 percent of skin cancers are melanoma, yet it is the most lethal type. Skin cancer is 20 times more common in Americans than in African Americans. Approximately, two million skin cancer cases were identified in 2010.Individuals with fair skin and more ultraviolet (sun) exposure are more prone to skin cancer. A biopsy is a golden diagnostic key for skin cancer. The other key components to diagnosing skin malignancies are history and physical examination. Skin cancer in children is rare, but melanoma occurs in children. The most important risk factor of skin cancer is ultraviolet exposure. Skin cancer in children can be prevented by increased use of sunscreen, low exposure to the sun, wearing hats and long clothes, and avoiding tanning beds.

What Is Skin Cancer?

In the US, skin cancer is the most prevalent type of cancer. Skin is the body's largest organ, consisting of the epidermis (outer layer), dermis (inner layer), and the lowermost tissue layer known as the tela subcutaneous. Cancer is a disease that causes improper cell cycle (a process by which cell grows in regular order) functioning, leading to tumor formation. The tumor is the abnormally rapid growth of the tissue. Tumors can be of two types: Benign (non-cancerous) and malignant (cancerous). Skin cancers that are not cancerous are known as non-melanoma skin cancers, which comprise basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Epithelial cells that have undergone keratinization give rise to malignant non-melanoma skin tumors.

Skin cancer can be of three types:

• Basal Cell Carcinoma - Basal cell carcinoma is the cancer of the epidermis, the outermost layer of the skin. Basal cell carcinoma is the most frequent type of cancer occurring in adults and children, but it is treatable. It occurs mostly on sun-exposed skin areas such as the head, neck, hand, leg, and face. The most prevalent type, BCC, is often slow-growing and locally invasive.

• Squamous Cell Carcinoma - This cancer is less common than basal cell carcinoma but is treatable. A squamous cell carcinoma affects the face, ear, lips, and mouth and appears as a scaly, itchy lesion on the skin. SCC accounts for 20 percent to 30 percent of non-melanomatous skin cancer, making it the second most prevalent.

• Melanoma - Melanoma is a fatal type of cancer. Melanoma refers to the cancer of melanocytes. Melanocytes are the cell that gives skin its color. Melanoma spreads rapidly and affects other body parts. Fair-skinned people are more prone to melanoma.

What Is Childhood Melanoma?

Childhood Melanoma refers to cancer of melanocytes. Melanocytes are cells that produce the pigment that gives skin its color. Melanoma in children is rare but generally diagnosed under the age of 18.

The following are the type of Melanoma arising in childhood

• Congenital Melanoma (melanoma present at birth).

• Congenital melanocytic naevus (a type of benign melanoma seen in infants present at birth and develops within a few weeks characterized by small hairy growth on the skin).

• Malignant blue naevus (a benign melanoma characterized by a blue mole located at the dermis of the skin).

• Nodular melanoma (it is the most aggressive type of melanoma, which grows rapidly and accounts for 40 to 50 percent of melanoma in children).

What Are the Risk Factors of Skin Cancer in Children?

Genetical defects generally cause skin cancer in children. Cancer in children is generally seen at the time of birth that the child inherits from the parents. The following are the risk factor for skin cancer in children

• Long-time exposure to the sun (ultraviolet rays).

• Fair-skinned people have more risk of developing skin cancer rather dark-skinned people.

• Previous family history of skin cancer can increase the risk of having skin cancer in children.

• Severe sunburns.

• Sunbathing and tanning are other risk factors.

• Long immunosuppression.

• Exposure to ionizing radiation.

• Moles or bumps have pus or blood filled within them.

• Chronic inflammation due to lacerations, scars, or other skin damage.

• Tanning bed exposure.

What Are the Symptoms of Skin Cancer in Children?

Children are most affected by melanoma. Skin cancer in children affects the head, face, eyes, hands, and arms. The following are the symptom of skin cancer in children

• Small raised bumps that can be itchy and start bleeding easily.

• Irregularly shaped brown, blue, pale, reddish, and pink mole on the skin.

• Flat or scaly bumps on the skin.

• The itchy, oozy, and crusty appearance of moles.

How Is Skin Cancer in Children Diagnosed?

Pediatricians (doctors specializing in children’s problems) are frontline providers who can detect skin cancer in its early stages and prevent disfigurement of the face in children.

The following are the ways to diagnose skin cancer in children

• Physical Examination - Pediatricians can detect skin cancer in children by physical examinations looking for its signs and symptoms.

• Biopsy - A biopsy is a medical test used to examine the suspected lesion of the patient under a microscope taken by excision from the site.A biopsy should be performed of any lesion suspected to be melanoma.

• Histopathological Examination - Histological examination is the gold standard for skin cancer diagnosis.

• Dermatoscopy - Dermatoscopy is a technique in which a dermatoscope (an instrument that helps detect skin cancer) is used to detect skin cancer. Using a dermatoscope to evaluate further the characteristics of a lesion in the clinical setting may be of some use. However, the help it may provide in detecting melanoma is limited by the operator’s training and experience.

How Is Skin Cancer in Children Treated?

1. The treatment of skin cancer in children depends upon the location, size, and stage of cancer.

2. Once the diagnosis is made from the biopsy clearing its stage, the treatment should be initiated promptly.

3. Early stages of cancer can be treated by excision of the lesion.

4. The excision of the lesion removes the suspicious mole or bump from the skin, leaving the healthy tissue behind.

5. Advanced ages of skin cancer require a combination of radiation therapy, chemotherapy, and surgical therapy.

6. Early treatment intervention and regular monitoring can cure cancer and have a good prognosis.

Conclusion

The most deadly form of skin cancer in children is melanoma. Early detection and primary prevention in children are crucial to lower the chance of getting cancer later in life. Primary prevention programs are more useful and effective in children, not only because sunshine exposure is especially important during this time but also because the children are more adaptable and more likely to acquire new attitudes and behaviors. Prevention is focused on proper protection from the sun whenever possible by using sunscreen, avoiding tanning beds, and wearing hats and long clothes. Parents should focus on teaching their kids how to protect themselves from the sun and promote behavior that prevents skin cancer.