MELANOMA (Cutaneous malignancy)
& NON-MELANOMA SKIN CANCERS (NMSCs)

This article is presented for general information only, it is not intended as an aid to self-diagnosis.
If you become aware of suspicious scalp head or neck lesions you should take medical advice without delay.

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Melanoma

A cancer arising from pigmented skin cells and body cavity linings. The incidence of this type of cancer is increasing worldwide. The International Agency for Research in Cancer has concluded that solar radiation, broad spectrum UVR, UVA (the most deeply penetrating wavelength), UVB and UVC radiations are all carcinogenic in laboratory animals.

In humans, excessive exposure to UVR increases the risk of serious adverse health effects especially cutaneous malignancies (skin cancer). The process may be thus described-

Excessive short-term exposure to UVR > 'sunburn' erythema (reddening through vasodilation) with oedema (swelling)
> 'suntan' due to increased melanin production > increased risk of eventual skin cancers (both non-melanoma and melanoma).

Melanomas can appear on the scalp.

Symptoms: a pigmented area which has recently appeared or changed in its colour, shape, size, or which begins bleeding or ulcerates e.g. a mole or nevus with varied colour, irregular borders, increasing in size or ulcerating.

Whereas the majority of scalp lesions have an almost nil risk of becoming melanomas, persons with suspicious lesions should visit their doctor without delay.

Diagnosis: by excisional biopsy which involves the complete removal of the pigmented lesion + a margin of surrounding normal tissue for gross and microscopic laboratory investigation.

Prognosis: Treatment methods are improving.

Treatment of melanoma is dictated by the stage of disease.

Thin lesions are more easily treated by surgical excision. The prognosis is usually excellent.

Thicker lesions evoke greater concerns. There is a possibility that other organs viz: regional lymph nodes in the neck, or the lungs, liver, or brain could be at risk. In such cases, physical examination, laboratory investigations and imaging may be required. Where there is no sign of metastasis (spread of disease to distant locations) treatment consists of excision of the primary tumor and possibly the removal of the lymph nodes in the neck for staging purposes.

Where metastasis is evident, treatment may involve a host of medical specialists and procedures beyond the scope of this article.

 

Non-Melanoma Skin Cancers (NMSCs)

(mainly Basal Cell Carcinomas and Squamous Cell Carcinomas).

NMSCs are relatively common in white skinned peoples., especially vulnerable are those with fair complexions and blonde or red hair. NMSCs are rarely fatal.

NMSCs can appear on the scalp

Symptoms: a pigmented area which has recently appeared or changed in its colour, shape, size, or which begins bleeding or ulcerates.

Whereas the majority of scalp lesions are harmless, persons with suspicious lesions should visit their doctor without delay.

Diagnosis: usually by excisional biopsy which involves the complete removal of the pigmented lesion + a margin of surrounding normal tissue for gross and microscopic laboratory investigation.

 

© B Stevens FTTS    Contact the author