How to tell the difference between a stubborn rash and little-known sign of killer skin cancer
MANY of us know to keep an eye our moles for signs of skin cancer.
Cancer charities and health experts often share the ABCDE checklist to recognise key warning signs of melanoma, known as the deadliest type of skin cancer.
Knowing the acronym can help you remember what to look for:
- Asymmetry – most melanomas are uneven or irregular in shape
- Border – the edges around a melanoma are likely to be uneven, irregular or jagged
- Colour – melanomas are usually more than one colour (e.g. have different shades such as brown mixed with black, red, pink, white or blue tint)
- Diameter – melanomas tend to be more than 6mm wide
- Evolving – look for changes in the size, shape or colour of a mole
Melanoma is considered so dangerous as there is a risk that it can spread to other parts of the body.
But there are other types of skin cancer which we might not be as trained to spot.
These are non-melanoma skin cancers, called basal cell carcinoma and squamous cell carcinoma, which start on the top layer of the skin.
While melanoma is considered more serious, a recent study found that non-melanoma skin cancer is causing more deaths worldwide as it’s far more common.
Its lead author Professor Thierry Passeron said: “In 2020, non-melanoma skin cancer accounted for 78 per cent of all skin cancer cases, resulting in over 63,700 deaths.
“In contrast, melanoma caused an estimated 57,000 fatalities in the same year.”
Consultant dermatologist and British Skin Foundation spokesperson Dr Derrick Phillips told Sun Health: “Basal cell carcinomas are a mild form of skin cancer that are becoming increasingly more common in the UK.
“Worryingly, I am starting to see basal cell carcinomas in under 30s, when previously they would occur after the age of 40.”
Some 156,000 cases of non melanoma skin cancer are diagnosed in the UK each year, making it “the most common type of skin cancer by far”, according to Cancer Research UK.
The charity noted that case numbers could also be higher, as they tend to be under reported.
The British Skin Foundation said that non-melanoma skin cancer accounts for 90 per cent of skin cancers and 20 per cent of cancer cases overall.
It added that basal cell carcinomas increased by 39 per cent between 2000 and 2011.
A spot or sore, a dark patch or itching, crusting and bleeding are telltale signs that you might be suffering from skin cancer.
But sometimes, they might show up on your in the form of something more benign.
In fact, you might mistake squamous or basal call carcinoma for a stubborn rash when they’re in their early stages.
Dr Jeffrey Hsu, an Illinois-based dermatologist told Insider about a patient who noticed persistent dryness, rashes and a few spots on her chest.
But what looked like a ‘simple rash’ stuck around for a couple of years despite the patient trying many treatments, which sparked concern for Dr Hsu. A biopsy revealed the spots to be squamous cell carcinoma.
Dr Phillips told Sun Health that a lingering scab might also be a red flag sign.
“A common story I hear in clinic is of a scab that fails to heal,” he said. “This could be an early sign of a basal cell carcinoma.”
How do I know if I have basal or squamous cell carcinoma?
According to Dr Phillips, basal cell carcinomas “are caused by exposure to harmful UV rays from the sun and usually appear as small, pearly, red growths on the skin with prominent overlying blood vessels”.
“Over time they will ulcerate and start to bleed,” he went on.
But he said this common form of skin cancer can be cured with skin surgery, adding that “early detection will often result in a smaller scar”.
The British Skin Foundation added that some basal cell carcinomas might look like a scaly red flat mark on the skin.
Most are painless, but might feel itchy or start bleeding if you catch it on something.
Squamous cell carcinoma can also vary in appearance – most will look scaly or crusty, raised and rough and they start on the outer layer of the skin.
There might be an ulcer that bleeds easily underneath that scaly surface.
Sometimes the ulcers can be sore and tender.
Who’s more at risk of skin cancer?
According to the British Skin Foundation, certain people might be more vulnerable to developing skin cancer.
It said basal cell carcinoma mainly affect adults with fairer skin who burn easily.
People who live in sunny climates or who spend lot of time in the sun because of work or hobbies might also be vulnerable.
Sunbathing or using sunbeds regularly can put you at higher risk too.
People with a suppressed immune system due to medical treatment or diseases and those who’ve had an organ transplant might be more susceptible to squamous cell carcinoma.
Sunburn and UV exposure are other risk factors.
Skin experts note that though people with lighter skin are vulnerable to skin cancer, it can most certainly affect people of colour.
How can I check my body for signs of cancer?
It’s recommended that you regularly check your skin for any changes, new moles, flesh coloured bumps, or flaky and raised coloured patches that don’t seem to be going away.
Keep an out for anything that seems to be growing in size, changing shape, developing new colours, crusting or going red around the edges.
To examine your skin, make sure your in a well lit room and it’s handy to have someone to help you.
A full length mirror or hand mirrors can be useful tools, as well as a comb to part your hair and a measuring tape to keep track of anything that seems to be getting bigger.
Use your phone to take pictures of any marks you think you should keep track of, so you can refer back to them.
Here’s how to examine your skin:
- Inspect your face and scalp closely – use a blow dryer or comb so you can see your scalp and use the mirrors to see the back of your head and neck if alone
- Check both sides of your hands – including fingernails and palms – and forearms before moving up to your elbows and upper arms
- Look at your your neck, chest and torso and lift your arms to look at your sides – don’t forget the underside of your breasts
- Examine your back, buttocks and back of your legs, with the assistance of a mirror or helper
- Sit down and check the rest of your legs, genitals and your feet, including your soles