Skin cancer is a change in some of the cells of your skin such that they grow abnormally to form a malignant tumor. These abnormal cells can invade through the skin into adjacent structures or travel throughout your body and become implanted in other organs and continue to grow, a process called metastasis.
The skin is the most common part of the body in which cancer develops. In the hand, squamous cell carcinoma is the most common type of skin cancer, followed by basal cell carcinoma and melanoma. There are other, more rare forms of skin cancer, such as Kaposi’s sarcoma, dermatofibrosarcoma protuberans, sweat gland tumors, and Merkel cell carcinoma, to name a few.
Skin cancer of the hand or wrist is uncommon, but it is possible. When it does occur, it’s usually squamous cell carcinoma, basal cell carcinoma, or melanoma.
Schedule an AppointmentSquamous Cell Carcinoma (SCC)
Squamous cell carcinoma (SCC) may look like small firm nodules on the skin. They are often brown or tan in color, and may include scaling, ulceration, oozing of fluid, bleeding, or crusting. The scaly, crusty top layer can build up, creating a cutaneous horn. Some people may mistakenly think that the cancer is just a cut or infection that just doesn’t seem to heal. Some SCC’s will present as large, mushroom-like growths. SCC has a significant potential to metastasize, especially to lymph nodes.
Basal Cell Carcinoma (BCC)
Basal cell carcinoma is classically described as a small, well-defined nodule with a translucent, pearly border, with overlying telangiectasias (abnormal superficial tiny blood vessels). These too may ulcerate and look like a chronic sore that won’t heal. They tend to be slower-growing and have with less of a tendency to metastasize, although they could.
Melanoma
Melanoma is one of the most common and dangerous forms of skin cancer. Melanomas often look like moles or birthmarks, but lesions that show increased growth, variations in color or shape, irregular borders, and/or are larger than 6 mm (1/4 inch) in diameter are suspicious for melanoma.
Melanomas have a very high potential to metastasize.
The letters “ABCDE” provide an easy way to remember these warning signs, any of which could suggest a melanoma:
- A: Asymmetrical
- B: Border (jagged or irregular)
- C: Color (uneven)
- D: Diameter (larger than the size of a pea)
- E: Evolving
Skin cancer is one of the most common forms of cancer and one of the most dangerous. However, it’s also one of the most treatable forms if it’s caught early enough.
Squamous cell carcinoma, basal cell carcinoma, and melanoma are all associated with chronic sun exposure, light or fair complexion, and immune suppression. Other factors include radiation exposure; exposure to certain chemicals, such as arsenic; and certain genetic conditions, such as xeroderma pigmentosum and Gorlin syndrome.
Pre-malignant lesions, such as actinic keratosis, cutaneous horns, and Bowen’s disease, may develop into squamous cell carcinoma. Family history and certain types of nevi (moles) may also indicate a predisposition to melanoma.
There are a variety of ways you can help prevent hand and wrist skin cancer as well as other forms of skin cancer.
Diagnosis includes inspection of the skin lesion, as well as a biopsy to determine whether the lesion is malignant or benign. A biopsy involves either taking only a small part of a big lesion or excising and removing a small one in its entirety.
The lymph nodes should also be examined because they are a common site for metastasis, especially for melanoma and squamous cell carcinoma. Other evaluation — such as sentinel lymph node biopsy, CT scan, and/or PET scan — may be needed to check for metastasis, especially with melanoma.
The standard therapy is surgical removal of the cancer with appropriate margins that are free of cancer cells at the edge of the excised tissue. Additional interventions such as skin grafting, tissue flap coverage, local amputation, radiation, and/or chemotherapy may also be needed.
The best treatment for skin cancer is prevention. Also, the prognosis is much better with early detection, so check your skin regularly and show any lesions to the doctor promptly.
If you have a suspicious mole or a sore that doesn’t seem to heal, don’t take any chances. Call the Arora Hand Surgery office in Warren, Macomb, Howell, or West Bloomfield to schedule a consultation and evaluation.
