Skin Cancer Check

Skin cancer results from unregulated growth of the cell types that make up the skin. The three most common forms of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma.

• Melanoma is the most serious form of skin cancer since it has the potential to spread elsewhere in the body. It can appear as a new pigmented area on the skin or a change in an existing mole.
• Basal cell carcinoma is the most common form of skin cancer. It generally is not dangerous to your overall health, however it can cause extensive local tissue damage if allowed to grow and therefore it is important that it is diagnosed early. Basal cell carcinoma usually has the appearance of a small, shiny lesion on the skin surface.
• Squamous cell carcinoma is less common than basal cell carcinoma, however it is more serious since it does carry a small risk of spreading elsewhere in the body. It usually presents as a fast-growing lump on the skin or a non-healing area.

A mole check is a proactive step in the early detection of skin cancer, by having a specialist skin doctor – a dermatologist – check moles and other skin lesions. Detecting skin cancer early increases survival rates, requires less invasive treatments, has a reduced risk of complications and prevents the cancer spreading to other parts of your body.

If you have a mole or other skin lesion that has changed in appearance (colour, shape or size), have moles that bleed, itch, ooze or crust over, or have new moles, we strongly recommend you have them checked.

All forms of skin cancer are more common in individuals who have had increased levels of sun exposure or who have used sun beds. Skin cancer is also significantly more common in those with lighter skin types. Other risk factors for skin cancer include:

• Individuals who have previously suffered from melanoma or other forms of skin cancer.
• Family history of melanoma.
• A large number of irregular moles.
• Immunosupressive medications, for example for an organ transplant.

Firstly, Dr Lynch will invite you to share any specific concerns you may have, and take a detailed history including any relevant family history of skin cancer.

Lesions of particular concern will be examined with a special microscope called a dermatoscope.

If you would like a full skin check, a comprehensive examination will be performed starting from the head and neck and working through all body areas.

Dr Lynch will take dermoscopic photographs of moles that require monitoring. If you have a large number of moles Dr Lynch can arrange for you to have mole mapping photographs taken (this will require a separate visit and additional charges will apply).

If you are female, a female chaperone will be present should you need to undress. You can also request a chaperone if you are male.

If Dr Lynch is concerned about a skin lesion then he may recommend a skin biopsy to be taken.

Either a sample of the lesion or the entire lesion is removed under local anaesthetic for analysis. Depending upon the nature of a skin lesion it can be removed either by cutting and stitching to leave a straight line scar or by shaving parallel with the skin surface and I will discuss the different options with you. The lesion is then sent for analysis by an experienced pathologist with whom I have a close working relationship and results are typically available within 1-2 weeks.

Dr Lynch has advanced training in skin surgery and have performed thousands of skin biopsies so where this is required I can perform this with minimal discomfort and scarring.

If the biopsy reveals more concerning findings or skin cancer, we will discuss the best course of action for your ongoing treatment. Dr Lynch is highly experienced in the treatment of all forms of skin cancer and can advise you as to the next steps.

Skin cancer can present as a new growth on the skin, a change in the appearance of a mole or a bleeding or ulcerated lesion. In general a new or changing lesion on the skin should be checked. The following is a simple method that can help to identify moles that may be of concern:

• Asymmetry: Harmless moles are generally symmetrical (one side is a mirror image of the other) whereas melanoma is more likely to be asymmetrical. Border: Harmless moles usually have a smooth, regular border whereas melanomas may have a rough, irregular border.
• Color: The presence of more than two colors (red, brown, blue, black) is more common in melanoma
• Diameter: Melanomas are more likely to have a diameter of more than 6mm.
• Evolution: Melanomas will usually change noticeably in appearance over a period of several months.

It is important to note that not all moles fulfilling one or more of the above criteria is a melanoma. Conversely, some (usually early) melanomas will not fulfill these criteria and may only be detected on microscope (dermascopic) examination of the mole.

If you have a number of irregular moles Dr Lynch may advise that you have mole mapping photographs performed. This enables me to monitor for any change in your moles over time.

The principle of mole mapping is that harmless moles either do not change in appearance or change very slowly over years whereas melanomas usually will change significantly in appearance over a number of months.

Mole mapping consists of photography of the skin surface. It serves as a photographic record of lesions on the skin for comparison in future consultations. The photography itself does not perform any analysis of the skin and does not replace a comprehensive examination of the skin by a dermatologist with a dermatoscope (microscope). For any moles that I am concerned about, I will take additional digital dermascopic photographs of the pigment pattern. This allows me to check for any subtle changes at a follow up appointment.

Even if you are having regular skin checks with a dermatologist it is important that you monitor your own skin at home. You should perform a full skin check every few months - this has the benefit that you learn what is normal on your own skin and learn to recognise any change.

An easy way to monitor for change is to take photographs of all of your skin (you will need help for some areas) and then repeat these photographs after a few weeks/months. If you notice any new skin lesions or any change in the appearance (size, shape, color) of existing skin lesions it is important that these are reviewed.

A new appointment including a skin check costs £250. Mole removal ranges from approximately £800-1000.