Skin Cancers

See Dr. Andrew Hendricks' website, SkinCancerAwareness.com for a full discussion on the diagnosis and treatment of Skin Cancer.

Actinic Keratoses (AKs)

About

ACTINIC KERATOSES (AKs)

Actinic keratoses (AKs), also called solar keratoses, are scaly, crusty growths (lesions) caused by damage from the sun’s ultraviolet (UV) rays. They are often elevated or rough in texture. Most become red, but some will be tan, pink, and/or flesh-toned. If left untreated, up to ten percent of AKs develop into squamous cell carcinoma (SCC) over the course of 10 years.

CAUSES

AKs are caused by years of ultraviolet ray (UV) exposure from the sun or indoor tanning beds. They are considered precancerous, and if left untreated, up to ten percent of AKs develop into squamous cell carcinoma (SCC) over the course of 10 years.

RISK FACTORS

Fair-skinned people with light-colored hair and eyes have a higher risk for developing AKs.
Excessive time spent in the sun.
Use of tanning beds or sun lamps, even if it was many years ago.
Prolonged residence in an area that gets intense sunlight, such as Florida, the Caribbean, or northern Australia.
Those with conditions or on medications that make them more sensitive to UV rays.

SYMPTOMS

A single AK may range from the size of a pinhead to larger than a quarter. Most AKs are dry, scaly, and rough textured, but not all AKs look alike. Some are skin colored and may be easier to feel than see. These AKs often feel like sandpaper. Other AKs can appear as red bumps, thick red scaly patches or growths, or crusted growths varying in color from red to brown to yellowish black.

Sometimes an AK grows rapidly upward, and you see a growth that resembles the horn of an animal. When this happens, the AK is called a "cutaneous horn." Horns vary in size from that of a pinhead to a pencil eraser. Some horns grow straight, others curve.

AKs often seem to disappear for weeks or months and then return. This makes treatment important. Left untreated, the damaged cells can continue to grow and skin cancer may develop.

When AKs develop, they tend to appear on skin that receives the most sun, including the:

Forehead, neck, chest, ears
Scalp, especially a bald scalp
Arms or hands
Lower legs, especially in women
Border of the lip (an AK on the lip and surrounding skin is known as "actinic cheilitis" and looks like a white or grayish scaly patch on a dry, often cracked lip)

DIAGNOSIS

AKs are diagnosed on a physical exam of theskin,but some may require a biopsy (sample) if they do not have a classic appearance.

Your dermatologist can perform a biopsy during an office visit using local anesthesia. It is quick, safe and easy to perform. Your dermatologist will take a sample of all or part of the suspicious skin, and the sampled skin will be sent to a lab where it can be examined under a microscope.

*SOURCE:

American Academy of Dermatology

Treatment

TREATMENT

Cryosurgery
This is the most common treatment for AKs. It involves freezing skin cells with liquid nitrogen to treat them and reduce the AK.
Photodynamic therapy
This treatment consists of 2 phases. First, a chemical is applied to the skin. This chemical is allowed to incubate for several hours. Then, the treated area is exposed to a special light that activates the chemical to cause reduction of potentially dangerous cells. This is best when there are multiple AKs on one body site (like the face, scalp, or hands and arms).
Curettage
A procedure that treats AKs by cutting or scraping (curettage) that can be combined with heat (electrosurgery) to treat diseased skin cells.
Chemical peel
A chemical solution is applied to the skin to penetrate the skin deeply to treat an AK.
Chemotherapy for the skin
5-fluorouracil is a cancer-fighting cream that you apply to the AK. The skin will become raw and irritated. As it heals, healthy skin appears. Another treatment such as cryotherapy may be necessary to treat thick AKs.
Immunotherapy for the skin
Imiquimod cream and ingenolmebutate gel are medications that work with the body's immune system to help destroy AKs.
NSAID (NON-STEROIDAL ANTI-INFLAMMATORY DRUG) for the skin
Diclofenac sodium gel is a medication that you apply to your skin and is recommended for skin with many AKs. It is an anti-inflammatory and anti-cancer treatment that fades AKs over a 30-day period.Additional in-office treatments may be needed following treatment with some of these topical prescriptions.
Research and development of other treatments for AKs is ongoing. No one therapy works on all AKs or in all individuals.

*SOURCE:

American Academy of Dermatology

Dysplastic Nevus/Atypical Mole

About

DYSPLASTIC NEVUS/ATYPICAL MOLE

A dysplastic nevus or atypical mole is a nevus (mole) whose appearance is different from that of common moles.

Dysplastic nevi often growto be larger than ordinary moles and may have irregular and indistinct borders. Their color may not be uniform and may range from light pink to very dark brown. They usually begin flat, but parts may rise above the skin surface.

According to the National Cancer Institute, researchers have shown that atypical moles are more likely than ordinary moles to develop into a type of skin cancer called melanoma. Although most atypical moles may never become malignant, numerous studies indicate that about half of melanomas arise from atypical moles. Epidemiology studies have also shown that individuals with multiple dysplastic nevi are at much higher risk for developing melanomas.

Patients with a personal or family history of skin cancer or of dysplastic nevus syndrome (multiple atypical moles) should see a dermatologist at least once a year to be sure they are not developing melanoma.

RISK FACTORS

People tend to inherit a tendency to develop atypical moles. Atypical moles are not cancerous, but people who have these moles have a higher risk of malignant melanoma, an aggressive and deadly form of skin cancer. Your risk of melanoma increases if you have atypical moles, have had a previous melanoma or a first-degree relative (parent, sibling, child) who has had a melanoma. A mole that stands out and looks different from other moles (known as the "ugly duckling" sign) can be dangerous and should be evaluated by a dermatologist.

*SOURCE:

American Academy of Dermatology

Treatment

TREATMENT

Cryosurgery
This is the most common treatment for AKs. It involves freezing skin cells with liquid nitrogen to treat them and reduce the AK.
Photodynamic therapy
This treatment consists of 2 phases. First, a chemical is applied to the skin. This chemical is allowed to incubate for several hours. Then, the treated area is exposed to a special light that activates the chemical to cause reduction of potentially dangerous cells. This is best when there are multiple AKs on one body site (like the face, scalp, or hands and arms).
Curettage
A procedure that treats AKs by cutting or scraping (curettage) that can be combined with heat (electrosurgery) to treat diseased skin cells.
Chemical peel
A chemical solution is applied to the skin to penetrate the skin deeply to treat an AK.
Chemotherapy for the skin
5-fluorouracil is a cancer-fighting cream that you apply to the AK. The skin will become raw and irritated. As it heals, healthy skin appears. Another treatment such as cryotherapy may be necessary to treat thick AKs.
Immunotherapy for the skin
Imiquimod cream and ingenolmebutate gel are medications that work with the body's immune system to help destroy AKs.
NSAID (NON-STEROIDAL ANTI-INFLAMMATORY DRUG) for the skin
Diclofenac sodium gel is a medication that you apply to your skin and is recommended for skin with many AKs. It is an anti-inflammatory and anti-cancer treatment that fades AKs over a 30-day period.Additional in-office treatments may be needed following treatment with some of these topical prescriptions.
Research and development of other treatments for AKs is ongoing. No one therapy works on all AKs or in all individuals.

PREVENTION

The most important thing you can do to protect your skin and prevent skin cancer is to limit sun exposure. Sun exposure is the most preventable risk factor for all skin cancers, including melanoma. The following behaviors can help prevent new skin cancers:

Seek shade.
Shade helps protect your skin from the sun's harmful UV rays. Shade is especially important between 10 a.m. and 2 p.m. when the sun's rays are strongest. But any time your shadow is shorter than you are, seek shade.
Wear protective clothing.
This means wearing a long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses, when possible.
Generously apply sunscreen that offers broad spectrum (UVA and UVB) protection, water resistance, and a Sun Protection Factor (SPF) of 30 or more.
Studies have shown that wearing sunscreen every day can reduce the risk of developing melanoma by half. Even on cloudy days, apply sunscreen to all skin that will not be covered by clothing. Reapply approximately every two hours, or after swimming or sweating.
Take care around water, snow, and sand.
These reflect and intensify the damaging rays of the sun.
Avoid tanning beds.
Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look like you've been in the sun, you may wish to use a sunless self-tanning product, but you should continue to use sunscreen with it.

*SOURCE:

American Academy of Dermatology

BASAL CELL CARCINOMA

About

BASAL CELL CARCINOMA

This is the most common type of skin cancer. It most often appears on skin exposed to the sun, such as the face, scalp, neck, hands, and arms, but can appear on any part of the body.

BCC may never metastasize, but they can grow deep and wide, affecting surrounding tissue and structures. This is especially concerning on the face where such alteration can affect the eyes and ears, and be cosmetically difficult to handle.

BCC often grows slowly. It may look like a:

Reddish patch of dry skin that won't heal
Flesh-colored (or pink, red, or brown) pearl-shaped lump with visible blood vessels
Pimple that just won't clear
Sore that bleeds, heals, and then returns
Scar that feels waxy - may be skin-colored, white, or yellow
Group of slow-growing, shiny pink or red growths that look like sores, often scaly and bleed easily
Flat or sunken growth - feels hard, may be white or yellow

RISK FACTORS

People of all skin colors can get BCC, although it is much more common in light-skinned people. The sun's ultraviolet (UV) rays damage your skin. Your everyday activities expose you to UV rays, such as going outdoors during the day without sun protection or when you drive your car or sit near your office window. Additionally, tanning beds emit dangerous UV rays, and their use is associated with developing BCC and other types of skin cancer.

Your risk of developing skin cancer increases as this damage accumulates. There are some people, though, who have a higher risk of getting BCC. For example, the risk increases with age. The older you are, the longer you have been exposed to the sun's UV rays. People may alsohave a higher risk of developing BCC when they have:

Pale, light-colored or freckled skin
Blonde or red hair
Blue, green, or gray eyes
A family history of skin cancer
A weakened immune system or are taking medicine that suppresses the immune system
Used tanning beds or other indoor tanning devices

DIAGNOSIS

To diagnose BCC, a dermatologist performs a skin biopsy. This is the only way to confirm a diagnosis of skin cancer, including BCC. Your dermatologist can perform a biopsy using local anesthesia during an office visit.

Your dermatologist will biopsy all or a representative sample of thegrowth, depending on its size and location on your body. This tissue will be sent to a pathologist to beevaluated under the microscopeto determine the diagnosis.

If the diagnosis is BCC, your dermatologist will consider many factors to determine the best treatment for you, including where the BCC appears on your body, the size and features of the BCC, and your overall health.

*SOURCE:

American Academy of Dermatology

Treatment

TREATMENT

When detected early and treated properly, the prognosis for BCC is excellent. Treatment cures most BCCs.

Treatment for BCC involves having one or more of the following.

There are many effective treatments. A dermatologist selects treatment after considering the following: the type of BCC, where it appears on the body, a patient's overall health. After considering this, one or a combination of the following treatment options may be recommended.

Surgical treatment: Surgical removal can be done in a dermatologist's office under local anesthesia using one of the following techniques. A small amount of normal skin is also removed,as skin cancer cells can microscopically involve normal-looking skin.

Excision: The lesion and a small amount of normal-looking skin (margins) surrounding the skin cancer are cut. What is removed is sent, like the initial biopsy, to a pathologist for microscopic examination to ensure all the margins are clear of the skin cancer. Stitches are used for wound closure.
Mohs surgery: A dermatologist who has completed additional training in Mohs surgery performs this procedure. The skin cancer and a much smaller margin of normal skin areremoved and checked immediately in the office. If any of the margins are still involved in the skin cancer, that specific area of involved skin is taken and rechecked. This occurs until all margins are clear. Once this is achieved, the surgeon may use different techniques, including flaps or grafts, to close the skin together.
Curettage and electrodesiccation: This surgical procedure may be used to treat shallow basal cell and squamous cell skin cancers. It involves scraping the tumor with a curette (a circular blade), followed by gentle cauterization (burning) of the site. This scraping and cauterizing process is typically repeated threetimes. The wound may heal without stitches.

Radiation therapy: Radiation may be used to treat older adults who have a large skin cancer, skin cancers that cover a large area, or a skin cancer that is difficult to surgically treat. Radiation therapy gradually reduces the cancer cells through repeated exposure to radiation. A patient may receive 15 to 30 treatments. Many years after a person is exposed to radiation, there is a risk of new skin cancers developing in the treated skin.
Topical Immuno- or chemotherapy: There are creams that a patient applies to the skin as directed by the dermatologist that can help the body's own immune system fight cancer, or intentionally damage the dangerous cancer cells.
Pills: In the very rare incidence that BCC spreads to other parts of the body, or in the case of a BCC that has become very large and is not amenable to traditional surgery or radiation, an oral medication may be an option.

*SOURCE:

American Academy of Dermatology

Malignant Melanoma

About

Malignant Melanoma

Melanoma is a type of skin cancer that develops from the pigment-producing cells (melanocytes) in the skin. Unlike non-melanoma skin cancers (basal and squamous cell carcinomas), melanoma can grow quickly and spread to other parts of the body. However, when detected early and treated, the cure rate can be very high.
Melanoma most often develops as a new growth, not in an existing mole. However, it is hard to memorize all existing moles, so regular skin checks looking for the following is important. The earlier the detection of the melanoma, the easier it is to treat.

A mole that is growing, changing shape, or changing color
A mole that looks scaly, oozes, or bleeds
New, dark spot on the skin that looks like a mole, but grows quickly
Pain, itch, or bleeding in a new spot on the skin
A streak (usually brown or black) underneath a fingernail or toenail
A bruise on the foot that does not heal

It is important to know that melanoma can also develop in the eyes, mouth, and genitals. Regular examination of these sites by a health care professional is recommended to screen for melanoma in these areas.

RISK FACTORS

Sun exposure is the most preventable risk factor for all skin cancers, including melanoma. Ultraviolet light (UV) from the sun and indoor tanning beds can cause skin cancer. Not all melanomas are caused entirely by UV rays. Heredity also plays a role. Research shows that if a first-degree relative (parent, brother, sister, or child) had melanoma, a person has a greater risk of getting melanoma.
In addition to a family history and UV exposure, some people have a higher risk of developingmelanoma,including those with:

Light skin, hair, and eyes
Fair skin that tans poorly or burns easily
Red or blond hair
Blue or green eyes
50 or more small moles
Moles called "atypical nevi" or "dysplastic nevi"
Past blistering sunburns or a history of indoor tanning
A previous melanoma or other skin cancer
Weak immune system (due to disease, organ transplant, or medicine)

Men over 50 are at a higher risk of developing melanoma compared to the rest of the general public. Melanoma can also affect younger people. In fact, melanoma is the second most common form of cancer in females aged 15–29years old.

DIAGNOSIS

A dermatologist will look carefully at all skin and examine growths, moles, and dry patches. To get a better look, a dermatologist may use a device called a dermatoscope or magnifying lens that helps to see pigment and structures in the lesion.

Concerning lesions will be biopsied. This involves biopsying the lesion or a sample of it for microscopic evaluation by a pathologist. A biopsy is quick, safe, and easy for a dermatologist to perform, usually in the same visit as your skin exam. A biopsy should not cause anxiety. The discomfort and risks are minimal.

*SOURCE:

American Academy of Dermatology

Treatment

TREATMENT

Your treatment depends on how deeply the melanoma has grown into your skin, whether the melanoma has spread to other parts of the body, and your overall health. Treatment often starts with surgery. In its earliest stage, melanoma grows in the epidermis (outer layer of skin). Your dermatologist may refer to this as melanoma in situ or stage 0. In this stage, the cure rate is nearly 100%.

Your dermatologist will want to treat all of the cancers. Your dermatologist can perform surgery in their office. You may remain awake during the surgical procedure. There are two common procedures for surgically treating melanoma:

Excision: Your dermatologist will numb your skin and surgically reduce the melanoma. Some of the normal looking skin around the melanoma will also be reduced. This procedure is appropriate for most in situ and invasive melanomas.
Mohs surgery: A dermatologist who has completed additional training in Mohs surgery performs this procedure. This procedure involves reducing visible skin cancer. The tissue that is treated is examined under a microscope by the Mohs surgeon to determine if there are any cancer cells remaining at any outer edges of the reduced tissue. During this time, you remain inthe surgical suite of office. If cancer cells are still present at any edge of the reduced tissue, the Mohs surgeon will continue to treat additional layers of skin or underlying affected tissue until cancer cells are no longer seen. This technique allows for thecomplete treatment of skin cancer yet minimizes the damage tohealthy skin. In most cases, Mohs surgery can be completed within a day or less.

When melanoma is caught early, excision or Mohs surgery may be the only treatment you need.

When melanoma grows deeper into the skin or spreads, treatment becomes more complex. It may begin with surgery, followed by additional treatment or more surgery. Treatment may also involve radiation therapy or chemotherapy to treat cancer cells. Some patients receive immunotherapy to boost their body's immune system, which increases the body's abilities to fight cancer. If the melanoma is advanced, the patient often receives a combination of these treatments by a team of physicians that may include a dermatologist, and surgical and medical oncologists.

It is important to note that numerous promising clinical trials are ongoing for the treatment of advanced melanoma.

PREVENTION

Sun exposure is the most preventable risk factor for all skin cancers, including melanoma. You can have fun in the sun and decrease your risk of skin cancer. Here's how:

Seek shade when appropriate. Remember that the sun's rays are strongest between 10:00 AM. and 2:00 PM. If your shadow appears to be shorter than you are, seek shade.
Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses, where possible.
Generously apply a broad-spectrum, water-resistant sunscreen with a Sun Protection Factor(SPF) of 30 or more to all exposed skin. "Broad-spectrum" provides protection from bothultraviolet A (UVA) and ultraviolet B (UVB) rays. Reapply approximately every two hours, even oncloudy days, and after swimming or sweating.
Research has found that daily sunscreen use cuts the incidence of melanoma in half.
Use extra caution near water, snow, and sand because they reflect and intensify the damaging rays of the sun, which can increase your chances of sunburn.
Avoid tanning beds. If you want to look tan, consider using a self-tanning product, but continue to use sunscreen with it.

*SOURCE:

American Academy of Dermatology

SQUAMOUS CELL CARCINOMA

About

SQUAMOUS CELL CARCINOMA

Squamous Cell Carcinoma is a common type of skin cancer that typically appears on sun-exposed skin because of increased Ultraviolet (UV) ray exposure. In these areas, SCCs can develop from untreated Actinic Keratoses. However, it is important to know that SCCs can appear elsewhere on the body, including inside the mouth, on the lip, or on the genitals.

Like Basal cell carcinomas (BCCs), SCCs can grow deeply and become locally disruptive, but it is important to note that they are slightly more aggressive and likely to spread to other parts of the body. This can be deadly. Certain locations are more prone to developing more dangerous SCCs: the lips, ears, and genitals.
SCCs can have the following appearances:

Hard, scaly,crusty, reddish bump or patch
An open sore that itches and bleeds; it may heal, but will return
Scaly or thickened patch on the lip

RISK FACTORS

People of all skin colors get SCC, although it is more common in Caucasians. Your everyday activities expose you to ultraviolet (UV) rays, which damage your skin. You receive this exposure every time you go outdoors during the day, whetheryou drive your car or sit near your office window.

People who use tanning beds have a much higher risk of getting SCC. They also tend to get SCC earlier in life. Your risk of developing SCC increases if you have any of the following factors:

Your physical traits

Pale or light-colored skin
Blue, green, or gray eyes
Blonde or red hair
An inability to tan

Your life experiences

Spent a lot of time outdoors, for work or leisure, without using sunscreen or covering up with clothing
Used tanning beds or sunlamps

Your medical history

Diagnosed with actinic keratoses (AKs)
Badly burned your skin
Have an ulcer or sore on your skin that has been there for many months or years
Taking medicine that suppresses your immune system, like those after an organ transplant
Infected with thehuman papillomavirus (HPV)
Had many PUVA light treatments
Have an inherited condition that increases the risk of SCC like xeroderma pigmentosa, epidermolysis bullousa, or albinism

Some SCCs begin as a precancerous growth called an actinic keratosis or AK. Most AKs share common qualities such as being dry, scaly, and rough-textured. A single AK may range from the size of a pinhead to larger than a quarter.

DIAGNOSIS

To diagnose SCC, a dermatologist performs a skin biopsy. This is the only way to confirm a diagnosis of skin cancer, including SCC. Your dermatologist can perform a biopsy using local anesthesia during an office visit.

Your dermatologist will biopsy all or a representative sample of thegrowth,depending on its size and location on your body. This tissue will be sent to a pathologist to evaluate under the microscope and determine the diagnosis.

If the diagnosis is SCC, your dermatologist will consider many factors to determine the best treatment for you, including where the SCC appears on your body, the size and features of the SCC, and your overall health.

PREVENTION

Keep all appointments with your dermatologist. When found early, skin cancer can often be cured.
Perform skin self-examinations. Examine your skin as often as your dermatologist recommends. Be sure to check your scalp, ears, genitals, and buttocks.
If you notice anything on your skin that is changing, itching, or bleeding, immediately make an appointment to see your dermatologist.
Protect your skin every day by:

Seeking shade. Shade helps protect your skin from the sun’s harmful UV rays. Shade is especially important between 10 a.m. and 2 p.m., when the sun’s rays are strongest. But any time your shadow is shorter than you are, seek shade.
Wearing protective clothing. This means wearing a long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses when possible.
Generously applying sunscreen that offers broad-spectrum (UVA and UVB) protection, water-resistance, and a Sun Protection Factor (SPF) of 30 or more. Be sure to apply the sunscreen 15 minutes before going outside. Apply it to all skin that clothing will not cover. You should reapply sunscreen every two hours, even on cloudy days. After swimming or sweating, you also need to reapply your sunscreen.
Protect your skin when around water, snow, and sand. These reflect and intensify the damaging rays of the sun.
Never use a tanning bed. UV light from tanning beds can cause skin cancer and wrinkling. If you want to look tan, consider using a self-tanning product or spray. Even when using one of these products, you need to use sunscreen.
Use condoms. This can prevent an HPV infection, which reduces the risk of getting SCC on the genitals.
Limit the amount of alcohol you drink and do not smoke. Smoking tobacco and drinking alcohol can increase your risk of getting SCC in your mouth.

*SOURCE:

American Academy of Dermatology

Treatment

TREATMENT

When detected early and treated properly, SCC is highly curable. There are many effective treatments. A dermatologist selects treatment after considering the following: the type of SCC, where it appears on the body,and a patient's overall health. After considering this, one or a combination of the following treatment options may be recommended:

Surgical treatment: Surgical reduction can be done in a dermatologist's office under local anesthesiausing one of the following techniques. A small amount of normal skin is also treated,as skin cancer cells can microscopically involve normal-looking skin.

Excision: The lesion and a small amount of normal-looking skin (margins) surrounding the skin cancer are cut. What is treated is sent, like the initial biopsy, to a pathologist for microscopic examination to ensureall themargins are clear of the skin cancer. Stitches are used for wound closure.
Mohs surgery: A dermatologist who has completed additional training in Mohs surgery performs this procedure. The skin cancer and a much smaller margin of normal skinare removed and checked immediately in the office. If any of the margins are still involved in the skin cancer, that specific area of involved skin is taken and rechecked. This occurs until all margins are clear. Once this is achieved, the surgeon may use different techniques, including flaps or grafts, to close the skin together.
Curettage and electrodesiccation: This surgical procedure may be used to treat shallow basal cell and squamous cell skin cancers. It involves scraping the tumor with a curette (a circular blade),followed by gentle cauterization (burning) of the site. This scraping and cauterizing process is typically repeated threetimes. The wound may heal without stitches.
Radiation therapy: Radiation may be used to treat older adults who have a large skin cancer, skin cancers that cover a large area, or a skin cancer that is difficult to surgically treat. Radiation therapy gradually reduces cancer cells through repeatedexposure to radiation. A patient may receive 15 to 30 treatments. Many years after a person is exposed to radiation, there is a risk of new skin cancers developing in the treated skin.

Because actinic keratoses can become squamous cell carcinomas, monitoring for and treating them is important. There are several options for the treatment of AKs.

*SOURCE:

American Academy of Dermatology

Skin Cancers

Actinic Keratoses (AKs)

ACTINIC KERATOSES (AKs)

CAUSES

RISK FACTORS

SYMPTOMS

DIAGNOSIS

*SOURCE:

Dysplastic Nevus/Atypical Mole

DYSPLASTIC NEVUS/ATYPICAL MOLE

RISK FACTORS

*SOURCE:

BASAL CELL CARCINOMA

BASAL CELL CARCINOMA

RISK FACTORS

DIAGNOSIS

*SOURCE:

Malignant Melanoma

Malignant Melanoma

RISK FACTORS

DIAGNOSIS

*SOURCE:

SQUAMOUS CELL CARCINOMA

SQUAMOUS CELL CARCINOMA

RISK FACTORS

DIAGNOSIS

PREVENTION

*SOURCE:

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