Common skin cancers in the United States: A practical guide for diagnosis and treatment

Cutaneous malignancies are the most common cancers found in the primary car e setting. It is imperative that all primary care providers become competen t in evaluating skin lesions. Actinic keratoses are the most common premali gnant lesions. These rough scaly plaques are the direct result of ultraviol et and other carcinogenic exposure. Actinic keratoses may be the first clin ical sign to alert primary care practitioners of severe solar dermatitis an d herald the development of skin cancer. Treatment is cryotherapy or topica l chemotherapeutic agents such as 5-fluorouracil. Basal and squamous cell c arcinomas are the most common nonmelanoma skin cancers. The primary cause i s cumulative exposure to ultraviolet radiation from the sun, although other factors exist. Treatment is generally surgical excision performed by a pra ctitioner skilled in this type of procedure contingent on tumor type, size, location, aggressiveness, and other factors. Other common treatments inclu de electrodesiccation and curettage and cryotherapy. The incidence of malig nant melanoma is the fastest rising cancer in the United States. Early dete ction and prevention are the mainstays of a good outcome. Depth of the lesi on is the primary determinant in staging and prognosis, although other fact ors are also important. As the incidence of skin cancer increases, primary care practitioners play an integral role in the diagnosis, treatment, and p revention of skin cancer. The importance of early detection and appropriate referral by primary care providers will become even more crucial in the pr ognosis of afflicted patients. Copyright (C) 1999 by W.B. Saunders Company.