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Skin cancer (skin carcinoma)

Skin cancer is the most common type of cancer. It tends to occur in patients over 50, particularly on the most sun-exposed areas of the face and body. The number of cases is constantly increasing, and sun exposure remains the main risk factor.

What Are the First Signs of Skin Cancer?

There exist two types of skin cancer which are characterised by different symptoms: melanoma and carcinoma.

Melanoma is a form of skin cancer which shows the following cutaneous signs:

  • the mole is asymmetrical;
  • it has irregular borders;
  • its colour is not homogenous;
  • its diameter is usually over 6 mm;
  • its size, colour, and thickness change over time.

Carcinomas are forms of skin cancer that usually develop after the age of 50:

  • Squamous cell carcinoma takes the shape of a small spot, pink or red in colour, covered by a scaly crust. This lesion will become ulcerated, wart-like, and will often bleed.
  • If you find a bumpy lesion, a few millimetres wide, it may be a basal cell carcinoma. This form of cancer is usually painless, firm, and translucent. Blood vessels run through the lesion, giving it a pink or red colour.

What Are the Different Types of Skin Cancer?

Basal cell carcinoma, the most common form of skin cancer, never metastasises but can be locally aggressive. Squamous cell carcinoma is rarer but it may metastasise around the lymph nodes or the organs and warrants close monitoring. Finally, melanoma is the most aggressive form of skin cancer, and also the deadliest one.

In any case, scientific certainty can be established through a diagnosis based on a biopsy. As for the main form of treatment, it remains surgery. After removing the lesion, the plastic surgeon compensates for the loss of tissue by applying various suture, skin graft, or local skin flap techniques. Another alternative is to rely on controlled wound healing, which allows the wound to close back up all by itself. In some cases, this method achieves excellent results, and it is even considered the optimal solution.

When in doubt as to melanoma or in cases where it constitutes an aesthetic discomfort, the naevus – or mole – can be removed. This is where Doctor Vincent Masson will perform a shave excision, an ellipse excision, or resort to laser mole removal.

Basal Cell Carcinoma

Together with squamous cell carcinoma, basal cell carcinoma counts among the non-melanotic types of skin cancer. Basal cell carcinoma makes up the majority of skin cancers. This type of skin cancer almost never results in metastases. Metastases are secondary tumours which develop some distance away from the original tumour.

Basal cell carcinoma usually affects sun-exposed areas of the skin, particularly the head, face, and neck. Most of the time, it appears in the form of a shiny papule on the skin, which gradually becomes larger. The papule may rupture, form a scab, and bleed. Basal cell carcinoma may also take the shape of a flat, pale white or yellow lesion, which can look like scar tissue or a small, smooth, shiny mass, pearl-white, pink, or red in colour.

The diagnosis usually begins with a clinical exam and is confirmed through a histologic examination. To counter this type of skin carcinoma, several types of treatment – mainly surgical – may be recommended to the patient. They consist in removing the tumour along with a margin of safety, to minimise the risk of relapse. The plastic surgeon will use several techniques: Suture removal in cases where the lesion is small, skin graft when the loss of tissue is significant, or skin flaps.

Squamous Cell Carcinoma

Also called epidermoid carcinoma, squamous cell carcinoma may occur on various areas of the body. Just as basal cell carcinoma, this form of skin cancer tends to develop on the areas most exposed to the sun, but not exclusively. It may also develop on the mucous membranes, on the nose, ears, back of the hands, arms, or legs.

Although it is 4 times less common than basal cell carcinoma, this type of skin cancer can cause lymph node metastases, which sometimes spread to the lungs. The appearance of squamous cell carcinoma varies depending on the area of the body where it is spreading. Typically, this type of skin cancer looks like a sore, or a skin ulcer. It can also take the shape of red patches, usually rough or scaly with irregular borders, raised growths with a hollow centre, or wart-like growths.

The dermatologist performs a clinical exam which provides a squamous cell carcinoma diagnosis. In most cases, this type of skin cancer is not lethal. When it is detected and treated in its early stages, the survival rate is very high. Treatment mainly relies on surgery. It may be supplemented with radiotherapy and chemotherapy. When this type of skin cancer is treated through surgery, restorative surgery may be necessary to cover the loss of skin tissue.


Melanoma is a type of skin cancer. It spreads from melanocytes, which are the cells responsible for the colour of the skin. This malignant tumour usually occurs on healthy skin. It can also develop from a pre-existing mole.

Melanoma usually manifests itself in the form of dark or black patches which can be flat, bumpy, or have an irregular surface. This type of skin cancer may develop either on the face or on the body. It can also appear on the mucous membranes, genitals, and even under the nails.

Melanoma treatment varies depending on how much the condition has progressed. There exist four different stages of the disease:

  • Stage 1 and 2 melanoma: Treatment is mainly surgical. Any suspicious lesion will undergo an excisional biopsy performed by a dermatologist or by a plastic surgeon.
  • Stage 3 melanoma: Treatment consists in surgery and immunotherapy. Chemotherapy and radiotherapy, particularly when the melanomas have already affected the lymph nodes or in the case of distant metastases, may also be part of the treatment strategy.
  • Stage 4 melanoma: Treatment relies on surgery and radiotherapy, as well as chemotherapy against the metastases.

Can Skin Cancer Be Cured?

Skin cancer, be it on the face or on the body, corresponds to the presence of abnormal cells within the skin. These cells multiply uncontrollably until they form a tumour. Depending on the type of skin cancer, these cells can either remain on the skin itself, or spread to the lymph nodes closest to the tumour. In the case of invasive melanoma, the cancer cells may also invade other organs. Healing from skin cancer therefore depends on the type of cancer and on how advanced it is.

To offer the right kind of treatment to skin cancer patients, doctors take various elements into account, such as the type of skin cancer (squamous cell carcinoma, basal cell carcinoma, or melanoma), where the cancer is located, the aesthetic impact of the skin cancer, as well as the patient’s own preference in terms of medical care.

After skin cancer treatment, it is crucial to keep monitoring the situation. The method and follow-up rate are determined on a case-by-case basis. Generally speaking, a follow-up consultation to perform a clinical examination will be scheduled every three to six months.

What Are the Risk Factors for Skin Cancer?

To lower the risk of skin cancer, it is crucial to protect your skin against ultraviolet radiation. Natural or artificial, UV rays are the underlying cause behind the large majority of skin cancers. UV radiation may be divided into three types:

  • UVA: UVA radiation accounts for about 95% of the UV rays that reach the Earth’s surface. These rays penetrate the dermis and are responsible for the immediate tanning process the skin undergoes.
  • UVB: UVB rays only penetrate the epidermis, yet they cause more damage than UVA radiation. They are responsible for the skin’s long-term tan, for sunburn, as well as for most forms of skin cancer.
  • UVC: Extremely dangerous even in very small doses, UVC rays don’t make it through the ozone layer and never reach the Earth.

The intensity level of UV rays is influenced by several factors such as the time of day, the season, and weather conditions. Our skin’s melanin production doesn’t protect us well enough against the noxious effects of UVA and UVB radiation. Sun protection is therefore the most effective way to safeguard your skin against this main cause of skin cancer.

Regular appointments with a skin health professional such as a dermatologist are recommended to prevent the development of skin cancer in Paris. It is essential to seek medical attention and check your skin regularly. This will help prevent any relapse and keep other similar lesions from appearing in other places of the body.


Dr Vincent Masson is a plastic surgeon with a post-graduate diploma in plastic, reconstructive and aesthetic surgery and a gold medal in surgery from the Paris Hospitals. He is a former senior registrar and attaché at the Hôpital Saint Louis.

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