SKIN CANCER SCREENING. A sore that does not heal, a crust that persists or a mole that grows requires medical attention because it may be skin cancer. What are the first signs not to ignore? Who to consult? Tour of warning symptoms with Dr. Isabelle Rousseaux, dermatologist.
[Mise à jour le 13 juin 2022 à 15h51] Lesion that struggles to heal, that bleeds, scabs, lumps with raised edges, strange mole, with irregular boundaries, irritated or itchy area… An area of the skin that changes appearance is not trivial. This is not necessarily a sign of cancer but it should be monitored by a health professional. What are the first signs of skin cancer ? Worrying ones? Suggestive of melanoma? A carcinoma? Who to consult? How to limit the risks? Tour of symptoms and good gestures with Dr Isabelle Rousseaux, dermatologist and venerologist in Lille.
The majority of moles are fortunately benign. But a mole that changes in appearance, color, shape, size, about 3 months should be monitored, as it may be a sign ofa melanoma. In 20 to 30% of casesskin cancer develops by degeneration of a pre-existing mole. The ABCDE rule (for Asymmetry, Edges, Color, Diameter and Evolution) can detect early signs of skin cancer. “If the mole becomes asymmetrical, if its edges become irregular, jagged or poorly defined, if its color is heterogeneous (it has darker areas than others), if it grows rapidly and exceeds 6 millimeters, it is necessary to to consult“, insists Dr. Rousseaux.
>> There exists so-called achromic melanomas, i.e. colorless. These small balls of the color of your skin can appear on the soles of the hand or foot. They are more difficult to detect because they are tone on tone, but fortunately remain relatively rare.
“Fortunately, in the majority of cases, the spots you have on your skin are benign pigmented (sun) spots. On the other hand, a pigmented spot ranging from pink to brown, which appears suddenly and/or which grows very slowly, should be monitored by the doctor.“, insists our interlocutor. To know that in 70 to 80% of casesa melanoma occurs on healthy skin (without moles or lesions).
>> A spot on the face can be Dubreuilh melanoma. This variety of melanoma is usually black or brown and looks like an age spot. It is not very serious and occurs mainly in people over 50 years old. It’s still something to watch out for.
“A small lump that appears on the skin may be a warning sign of nodular melanoma“, indicates our interlocutor. It is the second most frequent type of melanoma. “It descends and proliferates deep in the skin, like an iceberg“, she continues. It is easily recognizable because it is in the form ofa raised lump that protrudes above the surface of the skin, black, red, pink or the same color as the skin. It usually occurs on the face, chest or back, but sometimes it is visible on parts not exposed to the sun. If a small lump appears on the skin or grows larger, see your dermatologist.
“A small scab that gets bigger (usually within a few weeks) may be a sign of carcinoma, especially if it is localized to the mucous membranes (around the mouthat the corner of the eyes, of the nose), on the face or on the areas most exposed to the sun“, describes the dermatologist. In general, any wound or lesion on which we will put an ointment and which does not heal, and which in addition evolves, is suspicious and must lead to consultation.
- A basal cell carcinoma is more common on the skin (on the areas most exposed to the sun: the arms, the shoulders, the scalp in a bald man…), in the corners of the eyes, the bridge of the nose, the ears…
- A squamous cell carcinoma is more common in the mucous membranes (mouth, etc.).
A bleeding lesion is not serious if the bleeding was caused by rubbing or snagging. On the other hand, if the bleeding is spontaneous (without particular reason), there it is worrying. “It could reveal a tumor that has infiltrated deep blood vessels. This is not considered a warning sign because a bleeding lesion is usually a sign of melanoma or carcinoma that has already taken hold“, points out Dr. Rousseaux. It must therefore be monitored by a doctor who will make the diagnosis and guide the treatment.
“If the tumor goes deep and tends to tickle the nerve corpuscles, it can cause this area to itch“, observes the specialist. An itch that persists despite the application of a cream should prompt you to consult a doctor.
There are 3 types of skin cancer:
It is advisable to consult your GP or a dermatologist in the event of a change in the appearance of your skin (a wound/lesion which does not heal, a pimple or a scab which persists and/or changes, a mole different from the others (in its shape, size, color or its thickness), a new brown spot that appears on your skin…). “At the slightest worry on a mole, spot, pimple or lesion, seek medical advice. Fortunately, in 9 out of 10 cases, it’s nothing serious, but sometimes it’s a little more annoying and you have to either do a biopsy or remove the mass.“, insists the specialist. In all cases, a consultation allows, at best to remove the fears, and at worst to consider a care.
Frequency of monitoring by a dermatologist:
- When there is no particular risk: every 2 years.
- When you have a family history or already had a melanoma: every year.
Protecting yourself from UV rays is the best prevention against skin cancer. A few simple reflexes can limit the risks:
- Avoid exposing yourself to the sun between 11 a.m. and 4 p.m. and generally seek as much shade as possible. If you wish to expose yourself, do so in small increments (15-20 minutes for example), but avoid long sunbathing.
- If you are exposed to the sun, cover yourself with clothes, a hat and sunglasses. In the absence of clothing, apply sunscreen (at least an index 30, at best an index 50) every 2 to 3 hours, particularly on areas at risk of cancer (face, neck, shoulders, forearms, hands, etc.).
- Avoid using tanning booths: artificial UV rays are also bad and dangerous for the skin. Please note that UV cabins are prohibited for minors.
Watch your skin, especially if:
- You have fair skin, blond or red hair and you don’t tan easily
- You have freckles
- You have more than one quarantine moles on all the body
- You have large moles (more than 5/6 mm in diameter) and/or irregular
- You have a family history of melanoma
- You had severe sunburn during childhood or adolescence
- You lived a long time in a very sunny country
- You are often exposed to the sun through your job or your hobbies.
Thanks to Dr Isabelle Rousseaux, dermatologist-venerologist in Lille.
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