Skin Conditions & treatments

Common skin lesions of concern

Actinic Keratosis (AK)

Actinic keratoses are common, pre-cancerous skin lesions primarily caused by cumulative sun exposure. They typically present as rough, scaly, red or pink patches on sun-exposed areas like the face, chest, and arms, often feeling like sandpaper to the touch. Untreated, these lesions have the potential to progress into squamous cell carcinoma (SCC), a type of skin cancer.

Squamous Cell Carcinoma (SCC)

Squamous cell carcinomas typically appear on sun exposed areas of the skin and are usually due to chronic, ongoing sun exposure. SCCs normally appear as small, red, scaly sores that may have a “crusty” top appearance, but can appear in different forms. They often arise from an AK.

Basal Cell Carcinoma (BCC)

Basal cell carcinomas typically arise from sun exposure earlier in life, we consider this type of skin cancer the “safest” to have as it usually is very slow growing. BCCs commonly grow on the sun -exposed areas of the body such as the face, arms and legs. BCCs typically appear as small red bumps with a pearly border, but can appear in other forms as well.

Atypical Melanocytic Nevi/Dysplastic Melanocytic Nevi (AMN/DMN)

These are common non-cancerous lesions, but some may be abnormal enough to require further removal. AMNs/DMNs can be difficult to tell apart from a melanoma, and melanomas can sometimes arise from AMNs/DMNs. People with multiple abnormal nevi have a higher risk of developing melanoma in the future.

Melanoma/Melanoma in situ (MM/MMis)

This is considered to be the most severe type of skin cancer to have. Melanoma, in the early stages, can appear as a mole with abnormalities that defy the ABCDE’S of moles. Melanoma in situ (MMis) is considered the “safest” kind as it does not have the potential to spread. Invasive melanoma, on the other hand, has potential to spread, and its danger depends mainly on its depth.

Keratoacanthoma (KA)

A low-grade, rapidly growing skin tumor that originates from hair follicles. It typically appears as a dome-shaped nodule with a central keratin-filled crater, most often on sun-exposed areas such as the face, arms, or hands. While it resembles a squamous cell carcinoma and can be difficult to distinguish from it, keratoacanthomas often grow quickly over a few weeks and may spontaneously regress over several months.

Common benign conditions

Other common conditions

Treatments

Treatment for each cancerous and non-cancerous lesion is based on sub-type, size, location, depth, and other factors. Please refer to our “patients” tab to find care instructions for the below treatments except for Mohs.

Liquid Nitrogen (LN2)

LN2 is used to freeze the area of, and around, the lesion. After treatment, the lesion will blister and then fall off within 1-2 weeks. We often use LN2 for AK/SKs.

Efudex/Tolak (5-fluorouracil)

Efudex is a prescribed medication used to treat skin cancers and pre-cancers. This treatment comes as a cream that is applied directly to affected areas of the skin. Specific instructions are provided for each situation.

Aldara (imiquimod)

Aldara is a prescription topical cream that works by stimulating the immune system to target abnormal skin cells. It is commonly used to treat actinic keratoses and certain superficial skin cancers. Temporary redness or irritation at the treatment site is common and expected during use. Specific instructions will be provided.

Daylight PDT

Daylight PDT (photodynamic therapy) is a treatment for actinic keratoses (sun-damaged, precancerous skin lesions). It uses a light-sensitizing cream (Metvix, methyl aminolevulinate) activated by natural daylight. The treatment is effective, convenient, and causes minimal discomfort. Since the active compound is metabolized from the moment of application, it’s important to follow the timing closely.

Electrodessication and Curettage (ED&C)

An ED&C is a treatment where the remainder of the lesion is removed, and then the base is gently scraped and cauterized to ensure there is no skin cancer left. Please note electrodessication is contraindicated for patients with pacemakers or other implanted cardiac devices.

Shave Biopsy

A procedure where a blade is used to “shave” off a small sample of the skin. This sample is then sent to the lab for testing.

Punch Biopsy

For a punch biopsy we use a tool called a “punch” to remove a deeper section of skin to be sent to the lab for testing. Punch biopsies often have some stitches afterwards.

Excision

A procedure where we take a deeper, full thickness skin sample along with a safety margin and then close the defect with either stitches or surgical glue (depending on the site/size)

Mohs Micrographic Surgery

Mohs surgery is a technique where cancerous layers of the skin are removed and examined under a microscope. The process is repeated until no further cancerous tissue is found on the specimen taken. This can take several hours. As we do not perform this procedure at our clinic, we would refer you to one of the Mohs surgeons in the city.