Benign melanoma arises in the upper layers of the skin and is 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.
More than 102,000 new cases are registered each year in the United Kingdom. Still, 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.
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 disseminating 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, Bowen’s disease (precursors of squamous cell carcinoma), and some occupational exposure to coal tar, soot, mineral oils, arsenic, and possibly creosote and petroleum refining.
Symptoms of benign melanoma
- The scaly area does not heal the skin.
- Red or pink lesions are 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.
- 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
- Radiation exposure.
- Exposure to industrial chemicals such as solvents or vinyl chloride.
Diagnosing 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 the excisional biopsy indicates that a tumor may not have been wholly 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 these nodules may be eliminated.
Curettage and electrocautery can be used for superficial small basal cell carcinomas, but their use decreases. 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 combined with light-sensitizing drugs to destroy cancer cells. It is more beneficial 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 beneficial for small and large tumors, 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 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 the early stage and Bowen’s disease and involves the application of imiquimod cream to the affected area.