Benign melanoma: Risk Factors, Symptoms, Causes, Diagnosis and Treatment

Benign melanoma arises in the upper layers of the skin and are extremely common.

74% of these are basal cell carcinomas (sometimes called rodent ulcers), 23% are squamous cell carcinomas and the other 3% are a mixed group of rare skin cancers.

There are more than 102,000 new cases registered each year in the United Kingdom, but the exact numbers are difficult to assess since it is estimated that approximately 30-50% of basal cell carcinomas (BCC) and 30% of squamous cell carcinomas ( CCE) are not entered in the cancer registry.

The benign melanoma is more prevalent in men, the proportion of men to women is 13:10. The incidence related to age increases after 40 years and reaches its peak in the group of more than 70 years.

They usually appear in areas exposed to the sun, mainly on the face, neck, bald scalp, arms, back of the hands and lower legs.

The risk of dissemination of these tumors is only 0.5% for CCB and 2-5% for CCE. Approximately 90% are cured successfully.

The risk factors for benign melanoma are:

Sun exposure and sunbeds (ultraviolet radiation) particularly in white skin patients, estimate that 50-90% of basal cell carcinomas and 50-70% of squamous cell carcinomas are related to UV radiation .

Outdoor workers have a 43% chance of developing a basal cell carcinoma and a 77% increased risk of developing squamous cell carcinoma.

Other risk factors also include previous skin cancer, psoriasis and Bowen’s disease (precursors of squamous cell carcinoma), as well as some occupational exposure to coal tar, soot, mineral oils, arsenic and possibly creosote and petroleum refining.

Symptoms of benign melanoma

  • Scaly area that does not heal the skin.
  • Red or pink lesion not curative.
  • Bulk or ulcer that does not heal that coats / bleeds / itches or sometimes breaks down and becomes an ulcer.
  • Evolution of the lesion or change in appearance.

Causes

  • Solar exposition.
  • Severe and bullous burns in childhood or adolescence.
  • Light-colored skin, blond hair, red hair or light eyes.
  • Presence of large moles, numerous moles or unusual moles.
  • Family history of melanoma.
  • Weakened immune system
  • Exposure to radiation.
  • Exposure to industrial chemicals such as solvents or vinyl chloride.

Diagnosis

The ways to diagnose a benign melanoma will include a skin biopsy and possibly a dermatoscopy.

Treatment of benign melanoma

It depends on several factors:

  • The type of skin cancer.
  • The size and position of the tumor
  • The stage of cancer.

Surgery: Surgery will depend on the size and position of the skin tumor. Initially an excisional biopsy will be performed to remove the lesion and a surrounding area of ​​healthy tissue, which may be suitable for small tumors.

If excisional biopsy indicates that a tumor may not have been completely removed, more surgery (wide local excision) may be done to remove more tissue and reduce the risk of recurrence.

In some cases of squamous cell carcinoma, which are more aggressive than basal cell carcinomas, malignant cells can be found in the local lymph nodes and elimination of these nodules may be recommended.

Curettage and electrocautery can be used for superficial small basal cell carcinomas, but their use is decreasing. It involves “discarding” the tumor from the skin and then using an electric needle to destroy the remaining malignant cells.

Photodynamic therapy : In this therapy, light sources are used in combination with light-sensitizing drugs to destroy cancer cells. It is more useful for some large superficial tumors.

Radiation therapy : Radiation therapy is often used to treat these skin cancers and is very effective. They often occur in areas of the body such as the face and neck where surgery can be quite disfiguring.

It is very useful for small and large tumors, for those that have spread to the deeper layers of the skin and those in which the surgery will have a poor cosmetic result.

In addition, it may be the treatment of choice if the surgery is rejected or if the patient is not fit for it.

Radiation therapy is sometimes prescribed after surgery (adjuvant) to reduce the risk of recurrence and is sometimes used to treat affected lymph nodes.

Chemotherapy : Topical chemotherapy is sometimes used for basal cell carcinomas and squamous cell carcinomas. This will involve the application of a cream containing fluorouracil (5FU) of chemotherapy in the area.

Immunotherapy : Immunotherapy is sometimes used for superficial basal cell carcinomas in early stage and Bowen’s disease and involves the application of imiquimod cream to the affected area.