Early detection and treatment of skin cancer

The incidence of skin cancer is increasing by epidemic proportions, Basal c ell cancer remains the most common skin neoplasm, and simple excision is ge nerally curative. Squamous cell cancers may be preceded by actinic keratose s-premalignant lesions that are treated with cryotherapy, excision, curetta ge or topical 5-fluorouracil. While squamous cell carcinoma is usually easi ly cured with local excision, it may invade deeper structures and metastasi ze. Aggressive local growth and metastasis are common features of malignant melanoma, which accounts for 75 percent of all deaths associated with skin cancer. Early detection greatly improves the prognosis of patients with ma lignant melanoma. The differential diagnosis of pigmented lesions is challe nging, although the ABCD and seven-point checklists are helpful in determin ing which pigmented lesions require excision. Sun exposure remains the most important risk factor for all skin neoplasms. Thus, patients should be tau ght basic "safe sun" measures: sun avoidance during peak ultraviolet-B hour s; proper use of sunscreen and protective clothing; and avoidance of suntan ning.