A few years ago I came across an old Disney cartoon entitled, “The Ugly Duckling.” I recognized it as one I had seen as a child. As the story goes a mother duck has many beautiful ducklings hatch but one does not look like the others. The odd looking duck is ostracized by his “siblings.” He is sad and lonely until he comes across some baby swans. Getting a glimpse of himself in the water, he recognizes that he is not in fact a duck but a swan. He joins the swan family and lives happily ever after.
When it comes to skin cancer, the “ugly duckling” phenomenon can be a helpful tool in the detection of skin cancer. The concept is based on the Sesame Street principle that one of these is not like the others. When it comes to skin cancer, our spots frequently don’t look or act like our other “normal” spots. Skin cancers generally are changing, growing over a few weeks to months time, tender to touch, rough, itchy, darker in color or just new and different than other spots. The goal is to find those spots early so that we can all live skin cancer free and happily ever after.
There are three principle types of skin cancer – basal cell carcinoma, squamous cell carcinoma and malignant melanoma.
Basal cell carcinoma occurs most commonly on sun exposed skin but can occur anywhere on the body. It frequently presents as a small skin colored to pink bump which grows very slowly. It can bleed with minimal trauma such as washing or drying the face. Basal cell carcinoma is very slow growing and is treated with surgery. It rarely spreads to lymph nodes or other parts of the body. If left untreated it can burrow into deeper tissues becoming much more complicated to treat and may have to be treated with surgery or radiation.
Squamous cell carcinoma is the second most common cancer of the skin. It occurs principally on the head and neck but can affect all parts of the body. It is generally easily treated with surgery but unlike basal cell carcinoma, squamous cell carcinoma can spread to lymph nodes and other organs. High risk areas include the lips and ears. It usually appears as a red, scaly, tender to touch bump on the skin that can double in size over the course of just a few weeks.
Melanoma is the most deadly form of skin cancer and can occur anywhere on the body . Melanoma frequently presents as a new or changing brown or black spot on the skin. It can spread into lymph nodes and almost any other organ of the body. Melanoma can be fast or slow growing. It can arise in an old mole or as a new mole.
The ABCDE’s of moles are used to help patients determine if a mole needs to be seen by a dermatologist.
Asymmetry – Melanoma lesions are often irregular, or not symmetrical, in shape.
Border – Melanoma lesions usually have irregular borders that are difficult to define.
Color – The presence of more than one color (blue, black, brown, tan, etc.) or the uneven distribution of color can sometimes be a warning sign of melanoma. Benign moles are usually a single shade of brown or tan.
Diameter – Melanoma lesions are often larger than a pencil eraser.
Evolution – Changing moles should be evaluated by a dermatologist. Generally our moles do not change visibly over short periods of time.
If you or a family member have noticed an “ugly duckling” on your skin give us a call at (435)628-6466.