There are two groups of skin tumors: benign and malignant skin tumors. Having a light skin tone, exposure to sunlight, solarium, radiation, smoking, HPV (human papilloma virus), chronic wounds, some genetic syndromes (xeroderma pigmentosum, albinism, epidermodysplasia verruciformis) and suppressed immune system (transplant patients, AIDS) are the defined risk factors of benign skin tumors.
The increased density of UV lights that reaches the Earth’s surface due to depletion of ozone layer is among the major causes for increased incidence of the skin cancer. Ultraviolet lights can also cause sunburn, aging of skin, skin spots and sun allergies. UVA lights primarily lead to aging of skin due to long-term skin damage while UVB lights with higher energy causes direct cell damage and they are the primary reason of sunburn. The sunspots on the skin exposed to the sun in all seasons such as face, décolleté, dorsum of hand and forearm that increase with aging can be an example of long-term aging effect of the sun.

How Can We Protect Ourselves from UV Lights?

95% of UV lights reaching to Earth’s surface are UVA and 5% of them are UVB. UVC light cannot pass through the atmosphere while it can be emitted by artificial light sources. It is known that all types of UV cause skin cancer. The most critical stage of sun protection is to avoid sun exposure from 10 o’clock in the morning to 4 o’clock in afternoon when the ultraviolet lights are most effective and making use of sunscreen a part of daily self-care. A sunscreen with at least 30 SPF (Sun Protection Factor) should be applied 20 to 30 minutes before the sun exposure and the sunscreen should be reapplied once every 2 hours. Wearing a hat and protective clothes with long sleeve and legs when spending time outdoors will help avoiding the harmful effects of sun.

Importance of Early Diagnosis in Skin Cancer

Most types of the skin cancer are curative when diagnosed early. The primary examination tool used for early diagnosis of skin cancers is dermoscope. Dermoscope or microscopic examination of the skin surface magnifies the lesion and ensures detailed visualization of skin structures that are too small to be seen with naked eye. Integrating the dermoscopes with a computer allows digital recording and monitoring.
Nevus develops when the melanocytes, the pigment cells, form clusters inside the skin. Nevi are expected to develop in lower number as the person ages. Melanoma, which is one of the malignant tumors of skin, can develop on the nevi in skin. Risk of melanoma is higher in congenital large nevi (>20cm) comparing to other nevi.  Changes in the current nevi and new nevi should be examined under dermoscope by a dermatologist for early diagnosis of melanoma.

How is Skin Cancer Diagnosed?

Too many nevi on body (100 nevi or more), past diagnosis of melanoma and presence of familial syndromes associated with genetic predisposition to melanoma require screening of nevi in the entire body. In the screening of nevi, examination should be performed at 3-, 6- or 12-month intervals while patient’s medical history, risks of skin cancer and appearance of current nevus are also considered. In those follow-ups, the suspected nevus is photographed or the entire body is photographed, if necessary, and a nevus map is formed with computed dermoscope.
To make the final diagnosis of skin lesions, it is generally necessary to excise the lesion partially or completely and send it to the pathology department. Diagnostic biopsies specimens of the skin do not worsen the lesion while they are necessary to make final diagnosis of the malignant skin tumors.
All malignant diseases of skin, particularly basal cell carcinoma, keratoacanthoma, squamous cell carcinoma, lentigo maligna, melanoma, Bowen’s disease, Paget’s disease of skin, mycosis fungoides and other skin lymphomas as well as Kaposi’s sarcoma, are treated and followed up at Dermatology (Dermato-oncology) outpatient clinic of Koç University Hospital. The patients are also evaluated in plastic surgery, oncology, hematology, radiology, radiation oncology and general surgery departments, when necessary.