Epidemiology
Skin cancer is one of the most commonly diagnosed cancers in the UK, with more than 86 000 cases diagnosed annually. There are two major types of skin cancer: melanoma and non-melanoma.
Aetiology
The main risk factor for both types is increased exposure to ultraviolet (UV) radiation. Short periods of intense sun exposure, which can result in sunburn, will increase the risk of melanoma. Chronic exposure increases the risk of non-melanoma skin cancers. Other factors such as skin type, family history and a previous history of skin cancer are important. Patients who have had a renal transplant have a 33-fold increased risk of non-melanoma skin cancer due to immunosuppressive therapy, and have a higher risk of melanoma.
Non-melanoma skin cancer
Basal cell carcinoma
This is the most common skin cancer and arises from the basal cell layer of the skin. The majority occur in sun-exposed areas of the skin. They rarely metastasise but can ulcerate and invade locally, which if left untreated can cause extensive damage, particularly around the ears, nose and eyes. This gave them the name ‘rodent ulcer’.
Basal cell carcinomas (BCC) usually have a pearly rolled edge, central ulceration and telengiectasia on the surface, although not all present this way. Other features include a persistent, non-healing sore, an erythematous scaly plaque (which may have been misdiagnosed as eczema or psoriasis), or a waxy papule with poorly defined borders.
Diagnosis is usually made on the visual appearance and biopsy is required to confirm the histological subtype.
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