Types of skin cancer
There are different types of skin cancer that are usually classified into two main categories. The first is melanoma. This type of cancer is a category in itself and is the one that dermatologists are most concerned about because of its life-threatening potential. This is the “malignant version” of a mole, i.e. a cancer derived from the skin’s melanocytes, the cells that produce pigment.
The second group is called “non-melanoma skin cancer” and includes the rest, the most common being basal cell carcinoma and squamous cell carcinoma. Both derive from the cells that form the structure of the epidermis, the most superficial layer of the skin and are called keratinocytes.
In most cases in our environment these two types of carcinoma do not have a fatal prognosis, but can be removed from the skin, which in many cases leads to cure. Some aggressive cases of squamous cell carcinoma (not basal cell carcinoma) may metastasize, which complicates the prognosis.
The undisputed cause of all these types of tumors, both melanoma and non-melanoma, is solar radiation, especially that of the ultraviolet spectrum
In the Caucasian race, basal cell carcinoma is clearly the most frequent skin cancer. However, interestingly, in people with albinism in Africa, squamous cell carcinoma (SCC) has been found to have a much higher incidence and is the one that ultimately shortens the life expectancy of most of these people in Africa.
Squamous cell carcinomas derive from skin lesions called actinic keratoses. These appear as small reddish, rough areas, often with a scaly surface, located in areas chronically exposed to the sun. In our environment they are usually diagnosed around the age of 60, but in people with albinism in Africa they can appear as early as childhood.
Actinic keratoses may appear to be innocent lesions, which in many cases resemble dry skin. However, it is important to recognize their origin and thus take action to prevent the development of skin cancer.
Prevention, the best treatment
A variable percentage of these actinic keratoses, which, depending on the source, is between 1 and 10%, may progress to squamous cell carcinoma. This is why the treatment of these apparently insignificant lesions is of vital importance in people with albinism to prevent their progression to a potentially lethal carcinoma.
Between 1 and 10% of actinic keratoses may progress to skin cancer.
However, let us not forget that going one step further would be to prevent even these actinic keratoses by promoting adequate sun protection from childhood through measures that include avoiding direct exposure to the sun, especially in the middle of the day, wearing appropriate clothing and using sunscreen lotions with broad-spectrum and high sun protection factor (SPF).
Dra. Lorea Bagazgoitia
Dermatologist, Co-founder and Medical Director of Beyond Suncare.