Fellowship-Trained Mohs Surgeon
The racial and ethnic composition of the population in the United States is gradually undergoing a transformation. Currently, over 50% of the population is considered Caucasian, but by the year 2050 over half of the population will be People of Color (POC). African Americans, Hispanics, Native Americans, and Alaskan Indians make up the majority of the POC. These changes in the population will focus the health care lens directly on the specific health concerns of POC, including the increased incidences and severity of diabetes mellitus, hypertension, and skin cancer. While skin cancer is relatively uncommon in POC, when it is diagnosed, it is typically in an advanced stage. Treatment of advanced-stage skin cancer, particularly melanoma in the late stages, is difficult and often results in a less than optimal outcome.
Skin cancer isn’t commonly seen in POC but may be of significant medical concern when it does occur. The most common skin cancer types are basal cell carcinomas (BCC), squamous cell carcinomas SCC) and melanomas, with SCC being the most common in skin cancer type POC and BCC being the most come in Caucasians. Caucasians. The development of both BCC and SCC is thought to be influenced by ultraviolet light exposure in Caucasian patients. However, UV light exposure is not felt to be the major contributing factor for the development of skin cancers in POC, but a significant number of BCCs that occur in POC appear in sun-exposed areas. SCCs that occur in POC often arise in areas of chronic inflammation, preexisting scars or injuries to the skin, hidradenitis suppurativa, perianal warts, and skin ulcers. Melanomas that occur in POC often begin on the plantar surface, under a fingernail, on the palms, and inside the mouth. The early presentation of melanomas appears innocuous, generating little attention, so patients should learn the warning signs of various types of skin cancers.
What skin cancer signs should you look for?
- New mole, growth, dark spot, or a dark patch enlarging, bleeding or changing
- Red or dark patch that is bleeding
- Sore that is healing slowly; it may be in an old scar or a persistent rash or dermatitis
- Tender red, scaly patch
- Pigmented streak adjacent to or under a nail
BCC can appear very similar to benign moles, while SCC may resemble a patch of psoriasis or eczema. Melanoma may appear as a patch of hyperpigmentation or discoloration with very subtle changes in color.
Where should I look for skin cancer?
Skin cancers in POC often present in areas that aren’t exposed to UV light. They present with signs that may not be typically seen in the general population. Skin cancers can have a wide range of colors and shapes, textures, and sizes, and most of the time they aren’t symptomatic.
When examining your body:
Perform a full-body examination including the scalp, ears, the bottoms of the feet, groin, perineum, legs, finger, and toenails.
- Make sure your physician or dentist examines the inside of your mouth
- Have your hairdresser examine your scalp
How should I look for skin cancer?
- Use a full-length mirror whenever possible
- Have your hairdresser or barber examine your scalp
- Use a handheld mirror or the assistance of a partner to examine difficult to see places
How often should I look for skin cancer?
- Perform self-examinations every 1 to 3 months
How can the risk of skin cancer be reduced?
- Avoid the periods of highest sun exposure: 10 am – 4 pm
- Wear sun-protective clothing such as a wide-brimmed hat to protect the face and neck and shoes to protect feet from local trauma
- Wear broad-spectrum sunscreen, SPF 30 with water resistance
Examples of Skin Cancer on People of Color
Early detection saves lives
Regular self-evaluation for skin cancer, as well as, annual checks by a board-certified dermatologist is the key to a cure. If you have noticed an annual spot, or have not had a skin cancer screening in the last year, call your local Forefront dermatologist today. To find a location near you visit our website.