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Skin Cancer

Skin Cancer is a topic covered in the 5-Minute Emergency Consult.

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  • Most common cancer in US
  • Increasing incidence
  • 1 in 6 will have skin cancer during their lifetime
  • Actinic keratosis:
    • Premalignant lesion
    • Thickened scaly growth caused by sunlight or other artificial light source
    • Found on areas of body with high sun exposure
    • 0.1–10% may transform into squamous cell carcinoma (SCC)
  • Nonmelanoma skin cancer:
    • Less commonly fatal
    • Fast growing
    • May be destructive if left untreated
    • Basal cell carcinoma (BCC):
      • Cells arise from epidermis
      • Most common skin cancer
      • Account for 75% of all nonmelanoma skin cancers
      • Male > female, 3:2.
      • Locally invasive without risk of distant metastasis
      • Most important risk factor is sun exposure
      • More common in fair-skinned patients
      • Most lesions are on the head and neck
    • SCC:
      • 2nd most common skin cancer
      • 20% of cases of skin cancer
      • Most arise from precancerous actinic keratosis lesions
      • Male > female
      • Most important risk factor is sun exposure, especially sunburn
      • 70% occur on head and neck
      • More common in older, fair-skinned patients
      • Risk of regional lymph node and distant metastasis
      • SCC lesions of mucosal surfaces are more aggressive
  • Melanoma:
    • 5% of all diagnosed skin cancer in US
    • 62,000 new cases in 2008
    • 15% are fatal
    • 75% of skin cancer cause deaths
    • Arises from melanin-producing cells
    • Most important risk factor is sun exposure, especially sunburn
    • Additional risk factors:
      • Fair skin; blond/red hair
      • Multiple common melanocytic nevi
      • Atypical nevi
      • Immunosuppression
      • Positive family history
      • History of nonmelanoma skin cancer (BCC or SCC)
      • ≥5 sunburns in early life doubles the risk for malignant melanoma
    • Risk of regional lymph node and distant metastasis


  • UV irradiation:
    • Both UVA and UVB rays
    • Sun exposure
    • Tanning beds
  • SCC often associated with human papilloma virus (HPV)
  • Immunosuppression may predispose to SCC
  • Vitamin D metabolism may play a role

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Rosen, Peter, et al., editors. "Skin Cancer." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307201/all/Skin_Cancer.
Skin Cancer. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307201/all/Skin_Cancer. Accessed April 26, 2019.
Skin Cancer. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307201/all/Skin_Cancer
Skin Cancer [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 26]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307201/all/Skin_Cancer.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Skin Cancer ID - 307201 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307201/all/Skin_Cancer PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -