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Skin cancer (basal cell & squamous cell)

Carcinoma basocellulare et spinocellulare cutis · Rakovina kůže (bazaliom a spinaliom)

What it is

Basal-cell and squamous-cell carcinoma, the commonest cancers in fair-skinned people, grow from keratinocytes on sun-damaged skin; basal-cell carcinoma almost never spreads, squamous-cell carcinoma occasionally does.

Symptoms & signs

  • Pearly or waxy nodule with fine vessels
  • non-healing sore or crust
  • scaly, tender, growing patch
  • bleeding lesion
  • mostly on the face, ears, scalp and backs of the hands

🚩 Get help if…

  • see a doctor soon A sore or scab that doesn't heal within 4 weeks
  • see a doctor soon A fast-growing lump that bleeds or crusts
  • see a doctor soon A spot that keeps breaking down and healing over
  • see a doctor soon Hard lump in the neck, armpit or groin near a skin cancer

Where it strikes

Medical treatment

  • Excision with margins trials support
  • Mohs surgery for the face trials support
  • imiquimod, 5-fluorouracil or photodynamic therapy for superficial basal-cell carcinoma
  • radiotherapy when surgery is unsuitable
  • hedgehog inhibitors (vismodegib, sonidegib) for advanced basal-cell carcinoma — muscle cramps, taste loss and hair loss are common
  • cemiplimab for advanced squamous-cell carcinoma — FDA-approved 2018

Natural & lifestyle

  • SPF 50, hats and shade
  • no sunbeds
  • monthly self-checks
  • annual skin check if high risk (transplant recipients, many previous cancers)
  • vitamin D by supplement rather than burning

Emerging & experimental

  • Cemiplimab before surgery for resectable squamous-cell carcinoma
  • AI dermoscopy triage

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Nicotinamide (vitamin B3) 500 mg twice daily — the ONTRAC trial found about 23% fewer new basal and squamous cancers in high-risk people; no benefit in transplant recipients (ONTRANS) mixed evidence
  • Polypodium leucotomos (fern extract, 'oral sunscreen') — small studies of less sunburn early / small studies
  • Black salve and escharotic pastes — burn away skin, leave cancer behind and have caused disfigurement not confirmed in trials
  • Coconut and other oils as sunscreen — protection factor around 1 anecdotal / traditional

ICD codes