The diagram below is what your primary care physician looks for, but only when you bring it to his or her attention or if you have a primary care doctor who makes you strip to a gown when you get seen and picks it up (most docs don’t make you get naked because patients don’t like too).

Superficial spreading melanoma (above). Look at this and then look at
the go by chart above and figure out what about this lesion
makes it bad (don’t forget your ABCD’s)

Lentigo Maligna Melanoma (same thing, ABCD’s).

Acral Lentiginous Melanoma (less common but more common
in Asian or other dark skinned people. Can show up in
between toes, bottom of feet, or under nail bed).

Remember this pic next time you hear someone say
Melanoma is an easy cure and won’t kill me.
Try getting your wet suit on over this thing.

Very briefly I will go over and show a few pics of the other two main classes of skin cancer. Yes they do more often affect older people (older being 40yo and above). But then can occur at younger ages.
A basal cell carcinoma (BCC) usually looks like a raised, smooth, pearly bump on the sun-exposed skin of the head, neck, or shoulders.

• Small blood vessels may be visible within the tumor.

• A central depression with crusting and bleeding (ulceration) frequently develops.

•A BCC is often mistaken for a sore that does not heal.

Basal Cell Carcinoma

A squamous cell carcinoma (SCC) is commonly a well-defined, red, scaling, thickened patch on sun-exposed skin.

• Like BCCs, SCCs may ulcerate and bleed.

• Left untreated, SCC may develop into a large mass.

Squamous Cell Carcinomas

Two final take home points, prevention and who is responsible for your health.

Prevention

As mentioned in the previous newsletter with the sunscreen discussion, you need to use a sunscreen that protects you from UVA and UVB. It needs to be water resistant if you are surfing. It needs to be reapplied. The dermatologist that I work with says if it doesn’t have zinc oxide in it then it isn’t going to prevent Melanoma. Zinka is one of the sunblocks on the market that blocks UVA and UVB, it comes in different colors for the kids and adultd alike, and now it has new formula that rubs in (micronized zinc www.zinka.com ). There are other good products out there as well, just do your research before you drop the money.

Who is responsible?

We are. We need to put sun screen on every time we surf. I can’t wear stuff that runs in my eyes, it drives me nutz. I use Zinka because it doesn’t get in my eyes and I have never been burned using it. It also covers UVA and UVB, which means it prevents aging (deep pentrating UVA rays that damage collagen) and burns/cancer (UVB, superficial penetrating,top layers). Now that it has a thinner rub in formula you can apply it to the whole body.

We are also responsible for checking our own body. Routine self skin checks are key because most primary care physicians only get 11 minutes on average to review your record and see you when you go to the doctor. Health care today unfortunately places more responsibility onto the patient, but remember you are in charge of your health and body, your doc is a detective, guide, and advisor.

Monthly self-examination improves your chances of finding a skin cancer early, when it has done a minimum of damage to your skin and can be treated easily. Regular self-exam helps you recognize any new or changing features.

• The best time to do a self-exam is right after a shower or bath.

• Do the self-exam in a well-lighted room; use a full-length mirror and a hand-held mirror.

• Learn where your moles, birthmarks, and blemishes are, and what they look like.

• Each time you do a self-exam, check these areas for changes in size, texture, and color, and for ulceration. If you notice any changes, call your primary care provider or dermatologist.

Check all areas of your body, including "hard-to-reach" areas. Ask a loved one to help you if there are areas you can't see (yes, all the areas where the sun doesn’t shine).

• Look in the full-length mirror at your front and your back (use the hand-held mirror to do this). Raise your arms and look at your left and right sides.

• Bend your elbows and look carefully at your palms, your forearms (front and back), and upper arms.

• Examine the backs and fronts of your legs. Look at your buttocks (including the area between the buttocks) and your genitals (use the hand-held mirror to make sure you see all skin areas).

• Sit down and examine your feet carefully, including the soles and between the toes.

• Look at your scalp, face, and neck. You may use a comb or blow dryer to move your hair while examining your scalp.

When in doubt go see your doc. If you don’t have insurance go to an urgent care doctor to get seen, may cost you $100 but remember Melanoma accounts for 75% of skin cancer deaths and it happens to young people.

Surf safe and don’t play dumb.

Very Respectfully, Dr. D.