Introduction
The symptoms of malignant skin changes are insidious and are often not recognized and interpreted by medical laypersons or are recognized and interpreted too late. Malignant skin lesions either do not cause pain or only after the skin has long been infused with malignant tumor tissue. Pain in the early stages of tumor formation hardly ever occurs.
The leading symptoms of malignant skin changes are rapidly changing pigmented areas on the skin. In most cases, it is long-standing moles, which the affected persons have already become accustomed to seeing, that change shape, color and size. In dermatology, there is the so-called ABCD rule: A stands for asymmetry, i.e. moles change asymmetrically and proliferate strongly on one side, become oval or angular, and sometimes the otherwise straight structural boundaries are interrupted.
B stands for border, i.e. the edges of the suspect area become uneven, angular or interrupted. C stands for color, i.e. the color of a suspect skin area is not monotonously monochrome but restless with fast growing skin tones. D stands for the diameter, which changes rapidly and becomes larger.
If one or more of the factors ABCD apply to a suspect skin area, there is a high probability of malignant degeneration of the area. In this case a skin biopsy should be taken in any case. Since there is a risk of cell displacement in case of malignancy, in most cases the entire patch is cut out and histologically examined in medical pathology.
Another “symptom” of a malignant skin disease is a family history of skin cancer cases in recent years. Since it is known today that cancers, and in this case skin cancers, are genetically partly passed on and thus the risk of developing cancer increases in a person if cancer of any kind has already occurred in the family and close relatives in previous years, the patient’s medical history is particularly important if skin cancer is suspected. Furthermore, the patient should be asked whether he or she belongs to a risk group for skin cancer.
This includes years of sunshine on midsummer days, protected or unprotected. In addition, patients who frequently and regularly visit tanning salons are also at risk of developing skin cancer during their lifetime. Due to the often unspecific symptoms, a biopsy should always be obtained in case of doubt.
Many changes in the skin can be treated well if they are detected early. But that is exactly where the problem lies. Especially in the case of malignant melanoma, which is usually mentioned when talking about skin cancer, early detection is important because it grows quickly and metastasizes.
Since July 1, 2008, all persons in Germany with statutory health insurance from the age of 35 years have been entitled to a skin cancer early detection examination every two years. This should be used especially if you are exposed to a lot of sunlight. For this examination a special examination light, the dermatoscope, is used, which additionally facilitates the detection of degenerated tissue.
But even as a layman you should regularly take a closer look at your own skin, after all you know your own skin, your partner’s skin or the skin of your children best. A regular self-examination is recommended especially if, as already mentioned, you are exposed to a lot of sunlight, have a family history of increased risk of skin cancer or have a very light skin type. Also use a mirror to get a good view of body parts such as the back, neck, buttocks and soles of the feet.
Parts of the body that are not exposed to the sun, such as the mucous membranes of the mouth or the anal region, can be affected by skin cancer just like others. In order to better assess your skin and detect skin cancer earlier, there are two things you should pay particular attention to. Also noticeable are skin areas that are permanently reddened and itching.
Spots that bleed or change in shape and size are especially suspicious and should be presented to a dermatologist as soon as possible.
- First of all, pay attention to changes on your skin. If you notice “liver spots” that you did not know before, you should go to a dermatologist and have the area examined.Of course, there are also numerous benign changes in the skin, such as age spots.
However, if a certain spot seems strange to you, have it clarified further.
- Second: look for the “ugly duckling”. Since most people have considerably more than one mole, it is especially important to look for moles that are different from the rest. In case of doubt, it is better to have them removed.