SUSPICIOUS SKIN LESIONS

Although most skin lesions are benign and do not require any special treatment, they may become candidates for removal if they develop suspicious features. Changes in a lesion such as bleeding, pain, crusting, irregular pigmentation, or jagged borders may indicate the lesion could be cancerous and should be evaluated by a dermatologist for potential biopsy. Our team at Deschutes Dermatology in Bend, Oregon can perform a proper evaluation of any suspicious skin lesions and formulate a personalized treatment plan to address any potential issues.

What are the types of suspicious skin lesions?

Basal Cell Carcinoma (BCC): Basal cell carcinoma is the most common type of skin cancer. These lesions often appear as small, pearly bumps or flesh-colored growths that ulcerate or bleed. Patients frequently describe BCC as a “pimple that won’t heal.” Although BCC rarely spreads (metastasizes) to other parts of the body, it can cause significant local damage if left untreated. Early detection and removal are important for preventing complications.

Squamous Cell Carcinoma (SCC): Squamous cell carcinoma typically develops on areas of the skin that are chronically exposed to the sun, such as the head, neck, arms, and the back of the hands. These lesions can appear as rough, scaly patches, open sores, or wart-like growths. Unlike BCC, squamous cell carcinomas have the potential to spread (metastasize) to other parts of the body. Timely diagnosis and treatment are crucial for preventing serious health risks.

Melanoma: Melanoma is the deadliest form of skin cancer and requires immediate medical attention. It develops in the melanocytes, the cells responsible for producing pigment in the skin. Melanoma often appears as a new mole or a change in an existing mole.

Suspicious Skin Lesions: Why Early Detection Matters

For cancers like melanoma, early detection is especially critical. Melanoma can quickly invade deeper layers of the skin and metastasize to other parts of the body, making it far more deadly if not caught early. When melanoma is diagnosed at an early stage, it has a much higher cure rate. In fact, if treated before it spreads, the 5-year survival rate for melanoma is about 99%. However, once it reaches distant organs, this survival rate drops dramatically.

Even non-melanoma skin cancers, such as BCC and SCC, benefit from early detection. While these cancers are less likely to spread, they can still cause significant local damage. If left untreated, basal cell carcinoma can penetrate deeper into the skin and affect underlying bones and tissues. Squamous cell carcinoma can metastasize to lymph nodes and other organs, requiring more invasive treatment.

In addition to improving health outcomes, early detection minimizes the need for extensive surgery or more aggressive interventions, reducing scarring and improving cosmetic outcomes.

Detecting Suspicious Skin Lesions: What to Look For

A professional medical evaluation should be done for any new skin lesions or if changes have occurred in a previously assessed growth. If necessary, the lesion will be removed and sent to a skin pathologist for an evaluation. Following is a guideline that has been established to help patients check for changes or characteristics that may indicate precancerous or cancerous lesions.

A – Asymmetry – Does half of the lesion look different from the other half?
B – Border Irregularity – Are the edges of the lesion uneven, ragged, or blurred?
C – Color – Does the lesion have a variety of colors?
D – Diameter – What is the size of the lesion?
E – Evolving – Is the lesion changing or growing over time?

What methods are used for the removal of suspicious skin lesions?

If a lesion is suspicious of cancer, it will be removed by one of several methods, depending on which is most appropriate for the situation. Some lesions will be removed by shave technique, where a blade is used to scrape the lesion from the skin after it’s been anesthetized. Others will be removed by punch technique where, after anesthesia, a small metal tool (like a tiny cookie cutter) is used to score the skin’s surface, and the lesion is removed by snipping it free at its base. The resulting small hole is then closed with a stitch or two. Some lesions are removed by excision in an elliptical (football) shape with a scalpel and then closed with sutures.

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