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Skin Abnormalities: Separating Harmless From Harmful

By: Jennifer Linder, MD
Posted: January 28, 2011, from the February 2011 issue of Skin Inc. magazine.

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Squamous cell carcinoma (SCC). This has a red, rough or flaky appearance and often causes thickening of the skin. Ulcerations may occur and cause a chronic open sore. SCC primarily affects the superficial layers of the epidermis and approximately 97% of SCC does not spread; however, if metastasis does occur, scarring, disfigurement or death is possible.3

Melanoma. This is a dark-colored cancer of the skin’s pigment-producing cells, known as melanocytes. This is the most dangerous form of skin cancer due to its ability to metastasize and spread to lymph nodes, blood, distant tissues and organ systems. If detected and treated early while it is still thin, melanoma can typically be cured. Once it spreads, melanoma can be extremely difficult to treat and often leads to death. If a mole presents any of these characteristics, or if it changes in size, shape, color or texture, it should be emphasized to the client to have it evaluated by a dermatologist in the near future.

Cosmetic annoyances

The following skin concerns are completely benign. Although they will not cause harm, many require special treatment considerations. Many of these harmless lesions look similar to skin cancers; therefore, it is important that nonphysician skin care professionals have their clients properly diagnosed by a knowledgeable physician.

Moles. These are a completely normal part of human anatomy, and most adults will have 10–40 moles.4 Although they can be flesh-colored, the majority are dark in color because of the involvement of pigmented melanocytes in their development. Moles occur when multiple melanocytes grow bunched together. Although many moles are normal and harmless, clients prone to the development of moles are also more prone to skin cancer. Any mole that changes in size, color or shape should be examined to ensure it is not cancerous. If removal is desired—even if just for cosmetic reasons—moles should be surgically excised and examined by a pathologist.

Seborrheic keratoses (SK). These are typically dark-colored lesions that appear to be stuck on the surface of the skin. They are waxlike and often have a rough, uneven texture. SK are considered to be the most common noncancerous dermatological concern. They can be found anywhere on the body, but are more commonly found in sun-exposed areas. SK are not contagious and although their exact cause is unknown, they seem to be linked to heredity. Studies show that, although patients with SK can develop skin cancer and SK can look strikingly similar to skin cancer, this type of keratosis does not progress into a cancerous lesion.5 SK should be removed by a physician using electrocautery (burning the lesion with electric currents), cryosurgery or curettage. Treatment with chemical peels or microdermabrasion will not cause harm; however, complete clearance of SK is not typically possible with these methods of treatment.

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