LNE & Spa—the magazine for skin care and spa professionals September 2012
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skin
DEFINING
SKIN
CANCER
L
O VE YOUR SKIN, BECAUSE YOU
could be one of the two million new skin
cancer patients who are diagnosed annually. The identification of skin cancers and
the treatment has certainly become more scientific, but skin cancer has been a recognized
skin disease for centuries. French physician
René Laennec, who talked about cancer in a
lecture in 1804, is credited with being the first
to identify melanoma as a disease. It is believed that he also gave the disease its name.
Dr. Laennec’s findings were published in 1806.
It is proposed that the first person to have
actually operated on a skin cancer lesion was
Scottish anatomist and surgeon John Hunter
in 1787. Dr. Hunter did not know what the lesion was, although he said that it looked like a
“cancerous fungous excrescence,” translated
to mean “cancerous fungus.”
However, there is earlier evidence of skin cancer, which is found among writings of Cornelius
Celsus, who lived in the early part of the first century (28 B.C. - 50 A.D.). Celsus was a Roman encyclopedist who wrote on the topic of medicine
and translated the Greek word “carcinos” into
“cancer,” a Latin word meaning crab. Galen (130
A.D. - 200 A.D.), the last and most influential of
the great ancient medical practitioners, used the
Greek term “oncos” to refer to a growth or tumor
that looked malignant. It wasn’t until the beginning
of the 19th century when “carcinoma” became
a synonym for “cancer,” and the ending “oma”
was used to designate some cancerous lesions.
Ancient Arab and Greek writings also identify ailments that we now believe to have been
cancer. The writings claim that there is no treatment for the disease, but as far back as 300 B.C.,
Romans used ginger root to treat all forms of
cancer. Dioscorides, who wrote Materia Medica
in the fourth century, also lists the use of red clover and autumn crocus to fight cancer, and this
includes skin cancer.
The causes of skin cancer continue to be at
the forefront of modern medicine. Nutritional
deficiencies, lack of detoxification, free radicals,
depletion of ozone, use of chemical sunblocks and
cancer therapies themselves are all contributing
factors. Estheticians can play a key role in monitoring the health of their clients’ skin, and that includes checking for suspicious lesions or growths.
THE TWO MOST COMMON
TYPES ARE BASAL CELL
CANCER AND SQUAMOUS CELL
CANCER. THEY USUALLY FORM
ON THE HEAD, FACE, CHEST/
NECK, HANDS AND ARMS.
Skin disorders
The skin is the only system that can be observed
in its entirety for abnormalities and disease. It
can provide clues to underlying disease in the
body and reflect the state of its own health. Such
clues include changes in skin color, turgor (the
distension and displacement of fluid in the skin),
lesions and eruptions. A lesion can be defined as
a wound or other injury to the skin, with causes
ranging from systemic diseases; underlying infections; exposure to bacteria, fungi, viruses and
parasites; or an allergic reaction to food or drugs.
Lesions can be categorized as flat, elevated or
depressed, and can either be benign or cancerous. There are numerous types of benign lesions,
each having its own medical term, as shown in
the following list:
continues
BY ANNE C. WILLIS
September 2012 sLes Nouvelles Esthétiques & Spa
www.LNEONLINECOMsPage 29
can be confusing when trying to identify these
lesions and if they pose any danger. If caught
early enough, lives can be saved.
Rules for detection
melanoma
FLAT LESIONS:
s Macule: Flat, colored spot less than
1 cm in diameter (e.g., freckle).
s Plaque: Flat or lightly raised
lesion more than 1 cm in diameter.
ELEVATED LESIONS:
s Bulla: Raised, fluid-filled lesion
or blister greater than 1 cm
(e.g., severe poison oak).
s Nodule: Solid, raised lesion larger
than a papule, 0.6 to 2 cm in diameter
(e.g., small tumor).
s Papule: Small, circular, solid elevation
of the skin less than 1 cm in diameter
(e.g., wart, pimple).
The warning signs of skin cancer
Skin cancers, including melanoma, basal cell
carcinoma and squamous cell carcinoma, often
originate in the form of changes in the skin. They
can be new growths or precancerous lesions that
are not cancer, but could become cancer over
time. The two most common types are basal
cell cancer and squamous cell cancer. They usually form on the head, face, chest/neck, hands
and arms. In the past 30 years, there has been
a rise in skin abnormalities. Lack of nutrients,
adrenal fatigue, insulin resistance and pharmaceuticals have all contributed to this increase. It
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The three
major types of skin cancer:
Pre-cancerous: Actinic keratosis, hypertrophic
actinic keratosis or pigmented actinic keratosis
may appear as pink, skin-colored or gray, flat,
scaly growths that have a rough, “sandpapery”
feel when touched. Actinic keratosis cancers vary
in size but are often about the diameter of a pencil eraser, and range in thickness from barely elevated above the skin’s surface to a thick “warty”
growth. The word keratosis comes from the Greek
word “kerat,” which means “horn” or scale, and
the suffix “osis,” which means“condition.” The
word actinic is derived from the Greek word
“aktis,” meaning “ray.”
continues
Les Nouvelles Esthétiques & Spas3EPTEMBER
photos (top to bottom): Dean Bertoncelj/Shutterstock.com; Librakv/Shutterstock.com
MOST MELANOMAS
PRESENT AS A DARK, MOLELIKE SPOT THAT SPREADS.
UNLIKE A MOLE, IT HAS
AN IRREGULAR BORDER.
The following signs can help you detect cancerous skin changes.
Asymmetry: Normally, the moles that you
see on healthy skin are symmetrical. For example, if you divide them into exact halves, each
half of the mole resembles the other half. But
in cases of skin cancer, the moles are irregular
in symmetry, and each half of the mole does
not bear any resemblance to the other half.
Border irregularity: A normal or a benign
mole contains smooth borders. In cases of skin
problems such as cancer, the moles bear irregular borders that are uneven and may not even
be seen properly.
Color: Any color of the mole that is different from the regular brown color is important to
note. A regular mole will be one shade or color,
but a problematic mole will contain shades of
black or brown, and even red or blue lines may
be seen as the problem progresses.
Diameter: A mole generally has a diameter
of 6 mm. It should be noted when a mole is much
larger or smaller than this. A mole that continues to grow is even more cause for concern.
Evaluation: One last sign of skin cancer that
needs to be noted is elevation of the mole. A
mole is generally on the same level as the skin. If
a mole is found to be elevated with an irregular
surface, it should be checked for cancer. Cancerous
moles generally increase in height very rapidly.
Feel: A change in sensation, such as itchiness, tenderness or pain.
MELANOMA IS MOST
COMMON IN PEOPLE
MELANOMA IS MOST
WITH FAIR SKIN,
COMMON IN PEOPLE
BUT
OCCUR
WITH
FAIRCAN
SKIN,
PEOPLE
BUT IN
CAN
OCCUROF ALL
SKIN COLORS.
IN PEOPLE
OF ALL
melanoma
melanoma
s 3EBACIOUSHYPLASIA
s #OMMONWART
Benign skin lesions that
resemble squamous cell carcinoma
s +ERATOACANTHOMA
s %CZEMAATOPICDERMATITIS
s #ONTACTDERMATITIS
s 0SORIASIS
s 3EBORRHEICDERMATITIS
Benign skin lesions that
resemble malignant melanoma
s 3EBORRHEICKERATOSIS
(age spots/barnacles)
s 3OLARLENTIGINES
(sunspots/liver spots)
s -ELANOCYTICNEVI
s ,ENTIGINESFRECKLES
s "LUENEVI
s 0IGMENTEDBASALCELLCARCINOMA
Benign tumors
s %PIDERMOID
s ,IPOMAS
s #HERRYANGIOMAS
s $ERMATOFIBROMAS
photo: Ana Gram/Shutterstock.com
Basal cell carcinoma: Basal cell carcinoma is an open
Basalthat
cellbleeds,
carcinoma:
Basal
cell carcinoma
is anopen
openfor a few
sore
oozes
or crusts
and remains
sore
that
bleeds,
oozes
or
crusts
and
remains
open
for
weeks, only to heal up and then bleed again. aAfew
persistent,
weeks,
only
to
heal
up
and
then
bleed
again.
A
persistent,
non-healing sore is a very common sign of an early BCC.
non-healing sore is a very common sign of an early BCC.
Other types of basal cell carcinoma
Other types of basal cell carcinoma
s 3UPERFICIALBASALCELLCARCINOMA
s 3UPERFICIALBASALCELLCARCINOMA
s )NFILTRATINGBASALCELLCARCINOMA
s )NFILTRATINGBASALCELLCARCINOMA
3EBORRHEADERMATITIS
s s
3EBORRHEADERMATITIS
Squamous
cell carcinomas:
Squamous
cell carcinomas
Squamous
cell carcinomas:
Squamous
cell carcinomas
typically
appear
as a persistent
thick, rough,
scaly
patch that
typically
appear
as a persistent
thick, rough,
scaly patch
that
cancan
bleed
if bumped.
They They
also appear
as flat cells
thatcells
lookthat look
bleed
if bumped.
also appear
as flat
likelike
fishfish
scales.
The word
“squamous”
came from
thefrom
Latinthe
term
scales.
The word
“squamous”
came
Latin term
“squama,”
meaning
“the
scale
of
a
fish
or
serpent.”
They
often
“squama,” meaning “the scale of a fish or serpent.” They often
look like warts, and sometimes appear as open sores with a
look like warts, and sometimes appear as open sores with a
raised border and crusted surface over an elevated pebbly base.
raised border and crusted surface over an elevated pebbly base.
Bowen’s disease is a precancerous skin condition caused
Bowen’s disease is a precancerous skin condition caused
by abnormal cells growing in the epidermis. These cells
growing
in the epidermis.
These cells
areby
notabnormal
invasive orcells
malignant
(cancerous).
If left untreated,
are not
invasive
or malignant
(cancerous).
If left untreated,
Bowen’s
disease
may develop
into squamous
cell carcinoma.
Bowen’s
disease
may
develop
into
squamous
cell carcinoma.
Malignant melanoma: Melanoma is the most dangerMalignant
melanoma:
Melanoma
the most dangerous form
of skin cancer,
a malignancy
of the is
melanocyte,
theous
cell that
skin. Melanoma
formproduces
of skin pigment
cancer, in
a the
malignancy
of thecomes
melanocyte,
from
the
word
“melan”
from
melanocytes,
the
pigment
cells comes
the cell that produces pigment in the skin. Melanoma
of the
skin
plus
“oma,”
meaning
tumor.
Melanoma
is
most
from the word “melan” from melanocytes, the pigment cells
common in people with fair skin, but can occur in people of
of the skin plus “oma,” meaning tumor. Melanoma is most
all skin colors. Most melanomas present as a dark, mole-like
common in people with fair skin, but can occur in people of
spot that spreads. Unlike a mole, it has an irregular border.
all skin colors. Most melanomas present as a dark, mole-like
A susceptibility to melanoma may be genetically inherited,
that spreads.
Unlike a mole,
it sun
has and
an irregular
andspot
risk increases
with overexposure
to the
sunburn. border.
A
susceptibility
to
melanoma
may
be
genetically
inherited,
Other types of melanoma cancer
risk increases with overexposure to the sun and sunburn.
s and
3UPERFICIALSPREADINGMALIGNANTMELANOMA
s Other
.ODULARMELANOMA
types of melanoma cancer
s s
,ENTIGOMELANOMA
3UPERFICIALSPREADINGMALIGNANTMELANOMA
s s
!CRALLENTIGINOUSMELANOMA
.ODULARMELANOMA
Benign
skin lesions: There are a number of skin lesions
s ,ENTIGOMELANOMA
that are considered benign, but resemble skin cancers. The
s !CRALLENTIGINOUSMELANOMA
following represents some of these lesions:
Benign skin lesions: There are a number of skin lesions
Benign skin lesions that
that
are considered benign, but resemble skin cancers. The
resemble basal cell carcinoma
represents some of these lesions:
s following
&IBROUSPAPULE
skin lesions that
s Benign
4RICOEPITHLELIOMA
basal cell carcinoma
s resemble
+ELIOD
s &IBROUSPAPULE continues
s 4RICOEPITHLELIOMA
s +ELIOD Les Nouvelles Esthétiques & Spas3EPTEMBER
oto: Ana Gram/Shutterstock.com
SKIN COLORS.
TH
SKI
AB
MAK
TO
AND
Conclus
Skin has ch
through t
caring for
yond oily,
types. The
abnormal
skin care p
and be ob
best to re
Be sure to
client’s ski
Just as imp
ing your o
normal ch
noma
S
ma
CINOMA
skin|defining skin cancer
s 3EBACIOUSHYPLASIA
s #OMMONWART
Benign skin lesions that
resemble squamous cell carcinoma
s +ERATOACANTHOMA
s %CZEMAATOPICDERMATITIS
s #ONTACTDERMATITIS
s 0SORIASIS
s 3EBORRHEICDERMATITIS
Benign skin lesions that
resemble malignant melanoma
s 3EBORRHEICKERATOSIS
(age spots/barnacles)
s 3OLARLENTIGINES
(sunspots/liver spots)
s -ELANOCYTICNEVI
s ,ENTIGINESFRECKLES
s "LUENEVI
s 0IGMENTEDBASALCELLCARCINOMA
Benign tumors
s %PIDERMOID
s ,IPOMAS
s #HERRYANGIOMAS
s $ERMATOFIBROMAS
THE INCREASE IN
more than a cosmetic imperfection. It
SKIN LESIONS AND
could signify a threat to one’s health
and well-being.
ABNORMALITIES
MAKES IT NECESSARY
more than aAnne
cosmetic
imperfection.
It
C. Willis, a licensed
esthetician
TO STAY INFORMED
and worldwide leader in holistic and
could signify a threat to one’s health
AND BE OBSERVANT.
THE INCREASE IN
SKIN LESIONS AND
medical skin therapies, is the founder
of De la Terre Skincare. She is an accredand well-being.
ABNORMALITIES
ited skin care
Conclusion
instructor and
MAKES IT NECESSARY
Skin has changed in quality and depth
the director of
Anne C. Willis,
a licensed esthetician
through the years. The challenge in
Oncology Skin
TO STAY INFORMED
caring for the skin has developed
beTherapeutics™,
and worldwide leader in holistic and
yond oily, dry and combination skin
bringing more
AND BE OBSERVANT.
types. The increase in skin lesions and
than 30 years of
Conclusion
medical skin therapies, is the founder
experience and
of De la Terre
Skincare.
knowledge
to She is an accredthe new generation of skin therapists.
ited skin care
Willis co-authored The Esthetician’s
Guide to Working With Physicians, and
instructor and
has been featured in numerous publicathe directortions.
ofFor more information, contact her
at info@delaterreskincare.com or visit
Oncology Skin
www.delaterreskincare.com.
Therapeutics™,
bringing more
than 30 years of
experience and
knowledge to
the new generation of skin therapists.
Willis co-authored The Esthetician’s
Guide to Working With Physicians, and
has been featured in numerous publications. For more information, contact her
at info@delaterreskincare.com or visit
www.delaterreskincare.com.
abnormalities makes it necessary for
skin care professionals to stay informed
and be observant. When in doubt, it is
best to refer the client to a physician.
Be sure to document changes in your
client’s skin for their safety and yours.
Just as importantly, don’t neglect having your own skin checked for any abnormal changes! A blemish could be
Skin has changed in quality and depth
through the years. The challenge in
caring for the skin has developed beyond oily, dry and combination skin
types. The increase in skin lesions and
abnormalities makes it necessary for
skin care professionals to stay informed
and be observant. When in doubt, it is
best to refer the client to a physician.
Be sure to document changes in your
client’s skin for their safety and yours.
Just as importantly, don’t neglect having your own skin checked for any abnormal changes! A blemish could be
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