Skin Cancer Diseaeses

Basal cell carcinoma is the most common malignant skin tumour in Central Europe. It is sometimes called white skin cancer or basalioma. It is a malignant skin tumour that develops in the basal cell layer of skin tissue. Within this layer of skin it is destructive, but in less than one percent of cases it hardly ever spreads to other skin layers or tissue parts.

The most important aetiological  factor is chronic exposure to ultraviolet light. For this reason, basal cell carcinomas mainly develop on the face, but can basically occur on the whole body. Another risk factor is a light skin type. Due to changes in leisure behaviour (holidays in the high mountains, at the sea or use of solariums), basal cell carcinomas also occur in increasingly younger patients.

Basal cell carcinomas can take on different clinical forms. In the early stages, they appear as small, shiny nodules or redness, which can also resemble a scar. In the late stages they can grow proliferately, bleed and become encrusted. The diagnosis can usually be made clinically with a special magnifying glass (dermatoscope).

If the basal cell carcinoma is treated early, it is curable. As with other skin tumours (e.g. squamous cell carcinoma, melanoma), the aim is complete surgical removal, possibly in several operations ("two-stage operation").

Alternative forms of therapy depend on the subtype of basal cell carcinoma and other factors (including localisation, age and general condition of the patient): excochleation ("scraping"), cryotherapy ("freezing"), light therapy (photodynamic therapy - "PDT") or local therapy with an immunomodulator. However, recurrences are more frequent afterwards. In certain cases, especially if surgery is not possible for various reasons, radiotherapy is a good alternative therapy.

Basal cell carcinoma generally requires five years of follow-up care by a registered dermatologist, as the risk of developing another skin tumour is increased. A detailed clinical examination of the entire skin is performed. Apparatus-based examinations are not necessary.

Malignant melanoma (black skin cancer) is a malignant tumour that develops from the pigment-producing cells (melanocytes) that are located between the basal cells of the epidermis and are responsible for the pigmentation (melanin production) of the skin.

It can develop from healthy skin or from moles (moles, nevus cell nevi) as well as under the nails, on mucous membranes and the eyes. As with the light forms of skin cancer (e.g. basal cell carcinoma, squamous cell carcinoma), UV exposure, a light skin type and a genetic predisposition come into play in the development of melanoma.

To detect suspicious changes, the ABCD rule, which describes the clinical manifestation, has proven to be effective: A-asymmetry, B-limitation, C-colour (colour), D-diameter. However, not all melanomas can be detected by this. A lot of experience is necessary for this.

In early stages, melanoma can be cured by surgery. If left untreated, however, it usually leads to lymph node and organ metastases with limited chances of recovery.

As with many skin tumours (e.g. basal cell carcinomas, squamous cell carcinomas), surgical removal (depending on the thickness of the tumour, up to two centimetres safety distance) is the treatment of choice for melanoma. In addition, if certain fine tissue features of the melanoma are present, the sentinel lymph nodes can be removed and then an immunotherapy (interferon) can be carried out to strengthen the body's own tumour defence. In more advanced stages with tumour metastases (metastases of the melanoma), these can be surgically removed, irradiated or, in the case of extensive infestation, treated with chemotherapy or newer forms of therapy.

Aftercare for malignant melanoma is risk-adjusted. This is carried out quarterly over a period of ten years by your dermatologist and/or your treating clinic (special tumour follow-up consultation). In addition to the clinical examination, depending on the stage of the melanoma, an ultrasound diagnosis of the local lymph nodes and the abdomen, an X-ray examination and the determination of the tumour marker are carried out, among other things.

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