Medical Column: Now’s a Good Time for a Spot Check

By: Dr. Ethan McBrayer
Family Medicine Resident
Colquitt Regional Medical Center

As a family medicine physician, I diagnose a lot of skin cancers. As we all know it is sunny mostly in South Georgia. We each are guilty of not applying sunscreen as we should. I often tell my patients that the most common forms of skin cancer are basal and squamous cell carcinoma. Skin cancers are found on the sun-exposed areas of our face, ears, bald scalp, and neck. Basal and Squamous cell carcinoma spread slowly, and treatment for these are highly curable. On the other hand, Melanoma is the deadliest form of skin cancer and can rapidly appear anywhere on the body. If detected early, Melanoma is highly treatable. Individuals that have a higher risk for skin cancers include those who have a fair skin complexion. People who have used indoor tanning beds, people who have had sunburns, and people who have had a previous history of skin cancers.

Prevention and early detection are key to successful treatment so it is important to know how to perform a self-skin exam. The American Academy of Dermatology teaches that self-skin exams should be performed in front of a full-length mirror, looking at the front, back, right and left sides of your body. Attention to the elbows, forearms, underarms, palms, backs of legs, between toes, and soles of feet is also important. A hand mirror should be used to examine the back of your neck and scalp, low back, genitals and buttocks. 

What should you be looking for? Think A-B-C-D-E. A is for asymmetry, look for irregular spots where one half looks different from the other half. B is for border, look for a spot with an irregular, poorly defined border. C stands for color, look for different colors within the lesions. These colors can range from red to dark brown, a white spot, or even black. D stands for diameter, and any lesion that is bigger than a pencil eraser is concerning. E stands for evolving, which means any lesion changing rapidly in size, shape, or color is abnormal.

Wearing sun-protective clothing and applying sunscreen to sun-exposed skin daily is recommended as preventive measures. Tanning beds should be avoided completely, and should you notice a concerning lesion, your family physician or dermatologist will then examine your skin and decide if a sample of the skin needs to be biopsied and sent to a pathologist to determine if the lesion is cancerous. Treatment of skin cancer can vary according to the specific type of skin cancer, but generally includes minor surgery to remove the concerning lesion.

Your skin is the largest organ of your body. Pay attention to it, practice prevention, perform self-skin exams, and contact your family medicine physician or dermatologist if you see something concerning to you.