Healing By Secondary Intention
Secondary intention healing involves allowing the wound to heal spontaneously without suturing the edges together. During the healing time the wound needs to be cleaned regularly and ointment is typically applied several times per day to keep the wound moist. Depending on the size of the wound, healing can take weeks to months to complete, but eventually the open wound is covered with a new layer of skin that has grown in from the edges. Wounds that heal by secondary intention typically have more scar contraction and may have a lighter color or slight depression in height compared to surrounding skin. For most locations of the head and neck, secondary intention is not an ideal method of wound closure for these reasons. In specific circumstances, however, secondary intention healing may be recommended as a simple method of wound closure that does not require sutures or additional incisions.
Surgery For Basal And Squamous Cell Skin Cancers
Surgery is a common treatment for basal cell and squamous cell skin cancers. Different surgical techniques can be used. The options depend on the type of skin cancer, how large the cancer is, where it is on the body, and other factors. Most often the surgery can be done in a doctors office or hospital clinic using a local anesthetic . For skin cancers with a high risk of spreading, surgery sometimes will be followed by other treatments, such as radiation or chemotherapy.
How Are Basal Cell Carcinomas Treated
How we treat your basal cell carcinoma will often be dictated by its location. There are numerous treatment options.
Surgery is the typical treatment method. Depending on the size and location of the removed growth, the wound may be sutured closed, covered with a skin graft, or allowed to heal on its own.
These are the surgical procedures:
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What Are The Signs And Symptoms Of Basal Cell Carcinoma
Basal cell carcinoma is a type of skin cancer that can show up on the skin in many ways. Also known as BCC, this skin cancer tends to grow slowly and can be mistaken for a harmless pimple, scar, or sore.
Common signs and symptoms of basal cell carcinoma
This skin cancer often develops on the head or neck and looks like a shiny, raised, and round growth.
To help you spot BCC before it grows deep into your skin, dermatologists share these 7 warning signs that could be easily missed.
If you find any of the following signs on your skin, see a board-certified dermatologist.
Expert Review And References
- Christensen SR, Leffell DJ. Cancer of the skin. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Wolters Kluwer Health/Lippincott Williams & Wilkins 2015: 92:1314-1336.
- National Cancer Institute. Skin Cancer Treatment for Health Professionals . 2015: .
- National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Basal Cell Skin Cancer . 2015.
- Zloty D, Guenther LC, Sapijaszko M et al. Non-melanoma skin cancer in Canada chapter 4: management of basal cell carcinoma. Journal of Cutaneous Medicine and Surgery. 2015.
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What Is The Prognosis Of Superficial Basal Cell Carcinoma Of Skin
- In general, the prognosis of Superficial Basal Cell Carcinoma of Skin is excellent, if it is detected and treated early.
- Stage of tumor: With this lower-stage tumor, the prognosis is usually excellent with appropriate therapy
- The surgical resectability of the tumor
- Overall health of the individual: Individuals with overall excellent health have better prognosis compared to those with poor health
- Age of the individual: Older individuals generally have poorer prognosis than younger individuals
- Whether the tumor is occurring for the first time, or is a recurrent tumor. Recurring tumors have a poorer prognosis compared to tumors that do not recur
Basal Cell Carcinoma Overview
Basal cell carcinoma, also called epithelioma, is the uncontrolled growth of the skin’s basal cells. These are the cells that line the deepest layer of the epidermis, the skin’s outermost layer. This type of cancer rarely spreads to other parts of the body.
It is mainly caused by repeated long-term exposure to sunlight. Light-skinned people who spent a lot of time in the sun as children, or who spend time in tanning booths, are especially susceptible. X-ray treatments for acne and exposure to industrial pollutants such as arsenic and hydrocarbons also increase the risk of developing basal cell carcinoma.
Basal cell carcinoma is the most common skin cancer in the United States, with nearly 3 million cases diagnosed each year.
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Closure With 2 Suture Layers
The scar on the cheek is nicely hidden along the nasolabial crease and is almost imperceptible after healing in many patients. There are two layers of stitches. The underlying stitches cannot be seen in this picture because they are deeper below the surface. They will dissolve on their own. The top layer of sutures are the visible blue sutures and they are removed in approximately 1 week. If sutures are left in the surface too long, a railroad track type of scarring can occur. If sutures are taken out too early then some scars can spread and widen. With strong supporting stitches in the deep layer, removing top stitches 1 week after surgery usually yields the optimal result. After top stitch removal we often reinforce the healing skin by placing steristrips across the surface. These are like small pieces of reinforced tape that usually stay on for about one week and provide a little more support for optimal scar healing. More
Surgical Procedures For Basal & Squamous Cell Skin Cancers
Basal or squamous cell skin cancers may need to be removed with procedures such as electrodessication and curettage, surgical excision, or Mohs surgery, with possible reconstruction of the skin and surrounding tissue.
Squamous cell cancer can be aggressive, and our surgeons may need to remove more tissue. They may also recommend additional treatments for advanced squamous cell cancer, such as medications or radiation therapyenergy beams that penetrate the skin, killing cancer cells in the body.
Basal cell cancer is less likely to become aggressive, but if it does, our doctors may use surgery and other therapies to treat it.
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Johns Hopkins Offers A Solution
Jen headed to the Department of Otolaryngology Head and Neck Surgery at Johns Hopkins. I knew I was in the right place from the start, Jen says. Even the people at the front desk Everyone was excellent. Just what you want when you’re facing a severe trauma.
The surgery team offered Jen a solution. First, she’d undergo surgery to remove the large basal cell carcinoma. Later, Dr. Desai, an expert in reconstructive facial plastic surgery, would repair Jens nose in two stages. The first step would be a forehead flap procedure, surgically moving a section of living tissue from Jens forehead to cover the opening left after the cancer was removed. Then, once the flap had taken hold, he would rebuild Jen’s nose, using his skill to maintain its form and function.
Dr. Desai recalls his first meeting with Jen. It was emotional, he says. She was only 38, which is very young to have so many BCCs. She was understandably worried about how she could go back to work and how her kids would see her.
Doctors and patient talked things through. Despite facing a complex and painful series of surgeries, Jen says, I felt so much calmer. The surgeons were phenomenal. They were so knowledgeable and at the same time had the best bedside manner. They answered every question of mine and my husbands and took their time.
Living As A Basal Or Squamous Cell Skin Cancer Survivor
For most people with basal or squamous cell skin cancers, treatment will remove or destroy the cancer. Completing treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer growing or coming back. This is very common if youve had cancer.
For a small number of people with more advanced skin cancers, the cancer may never go away completely. These people may get regular treatment with radiation therapy, chemotherapy, or other treatments to help keep the cancer in check for as long as possible. Learning to live with cancer that does not go away can be difficult and very stressful.
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What Does A Basal Cell Carcinoma Look Like
BCCs can vary greatly in their appearance, but people often first become aware of them as a scab that bleeds and does not heal completely or a new lump on the skin. Some BCCs are superficial and look like a scaly red flat mark on the skin. Others form a lump and have a pearl-like rim surrounding a central crater and there may be small red blood vessels present across the surface. If left untreated, BCCs can eventually cause an ulcer hence the name rodent ulcer. Most BCCs are painless, although sometimes they can be itchy or bleed if caught.
What Causes Basal Cell Carcinoma
Basal cell carcinoma occurs when one of the skins basal cells develops a mutation in its DNA. Basal cells are responsible for producing new skin cells. As they do so, older skin cells are pushed toward the skin surface, where they die and are sloughed off. DNA in the basal cell controls this function.
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Can You Scrape Skin Cancer Off
During electrodessication and curettage, an outpatient procedure, doctors numb the skin using a local anesthetic and scrape off cancer cells with a tool called a curette, a small scoop that has sharp edges. They then apply electricity with a probe to stop any bleeding. This process is repeated several times.
What Are The Signs And Symptoms Of Superficial Basal Cell Carcinoma Of Skin
Superficial Basal Cell Carcinoma of Skin signs and symptoms may include:
- Superficial BCC of Skin is a slow-growing malignant tumor. The tumor has a typical presentation with a flat, pink, well defined patch, usually without scale
- The surface of the patch appears red , when intact. Else, it may appear with small erosions, if the surface has been traumatized
- The patches are often many in numbers and are typically observed on the chest and back , and other sun-exposed areas
- In children, if it is associated with basal cell nevus syndrome, then multiple lesions may be observed
- The lesions may range in size from a few millimeters to up to 10 cm
- The lesion may grow and there may be itching sensation, ulceration, and bleeding
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Can Basal Cell Carcinomas Be Cured
Yes, BCCs can be cured in almost every case, although treatment can be more complicated if the BCC has been neglected for a long time, or if it occurs in an awkward place, such as close to the eye or on the nose or ear.
BCCs rarely spread to other parts of the body. Therefore, although it is a type of skin cancer it is almost never a danger to life.
Mohs Surgery Is Very Precise
During Mohs surgery, a dermatologic surgeon like Maher removes skin from a skin cancer site one stage at a time. First, a dermatologic surgeon outlines the lesion with ink to map the tumor. After a local anesthetic is injected, the doctor removes the thinnest possible layer of cancerous tissue. While the patient waits, that layer is processed in an onsite pathology lab. After processing, the dermatologic surgeon can then examine the entire margin of removed tissue under the microscope to determine whether any cancer remains. If skin cancer persists, the dermatologic surgeon can identify the precise location of the remaining cancerous cells. At that point, the patient returns to the operating room so that the surgeon can take another layerand the process is repeated until all cancerous tissue has been removed. Roughly 80 percent of patients only need a single layer of skin removed in order to remove all the cancerous tissue. This layer-by-layer approach keeps the incision as small as possible to reduce scarring and promote healing.
Because of the way we process these tissue samples, looking at 100 percent of the margin, we can know for certain when weve removed all of the cancer, Maher said.
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The Pursuit Of False Perfection
So imagine my alarm years later when, in June 2015, my dermatologist, Patricia Mauro, MD, at the University of North Carolina , did a biopsy of a suspicious spot on my nose and informed me that I had basal cell carcinoma. My head started spinning, and it took me a few seconds to process. Dr. Mauro immediately escorted me to the Mohs Center at the university hospital to meet Brad Merritt, MD, who would soon become my Mohs surgeon and skin sculptor.
My thoughts drifted back to summer days as a teen, spent at the pool swimming and smearing iodine and baby oil on my skinny frame to amplify the suns effects.
In his office, my thoughts drifted back to summer days as a teen, spent at the pool swimming and smearing iodine and baby oil over my skinny frame to amplify the suns effects. Later, when I was a cheerleader at UNC, having bronzed limbs helped to set off the school colors, Carolina blue and white. A week before football season, we practiced cheers at the beach, and Who has the darkest legs? became our mantra. At the Tri Delta house, sunny days meant climbing onto our third-story roof to work on our tans without our greased bodies sliding into the gutters. All of this, it turns out, was sheer insanity for someone of Scotch-Irish descent like myself, with skin especially vulnerable to sun damage and prone to developing skin cancers.
Southern Cross Medical Library
The purpose of the Southern Cross Medical Library is to provide information of a general nature to help you better understand certain medical conditions. Always seek specific medical advice for treatment appropriate to you. This information is not intended to relate specifically to insurance or healthcare services provided by Southern Cross. For more articles go to the Medical Library index page.
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More Pictures Of Basal Cell Carcinoma
While the above pictures show you some common ways that BCC can appear on the skin, this skin cancer can show up in other ways, as the following pictures illustrate.
Scaly patch with a spot of normal-looking skin in the center
On the trunk, BCC may look like a scaly patch with a spot of normal-looking skin in the center and a slightly raised border, as shown here.
Basal cell carcinoma can be lighter in some areas and darker in others
While BCC tends to be one color, it can be lighter in some areas and darker in others, as shown here.
Basal cell carcinoma can be brown in color
Most BCCs are red or pink however, this skin cancer can be brown, as shown here.
Basal cell carcinoma can look like a group of shiny bumps
BCC can look like a group of small, shiny bumps that feel smooth to the touch.
Basal cell carcinoma can look like a wart or a sore
The BCC on this patients lower eyelid looks like a wart* in one area and a sore** in another area.
If you see a spot or growth on your skin that looks like any of the above or one that is growing or changing in any way, see a board-certified dermatologist.
Laser Surgery Is Not Fda
Laser surgery is not currently used as a standard treatment for basal cell carcinoma or squamous cell carcinoma. It can, however, be an effective secondary treatment. Laser treatment is sometimes used after Mohs surgery to complete the removal of cancer cells. Lasers are effective at removing precancerous lesions, but have not been proven effective at treating cancer yet.
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Basal Cell Carcinoma: The Most Common Skin Cancer
Basal cell carcinoma, or BCC, is a form of skin cancer that arises from basal cells deep in the lining of the skins top layer, the epidermis.
It’s common: According to the Skin Cancer Foundation, over 4 million cases of BCC are diagnosed each year in the U.S. alone. As most people know, its associated with frequent or prolonged sun exposure.
If theres something good to say about BCC, its that most cases are manageable. Its a slow-growing cancer that seldom spreads. Also, BCCs occur on the skin, usually where they can be readily seen. Surgical removal is an effective treatment.
But when a BCC grows undetected, it can become more serious.
I can’t even say how phenomenal Dr. Desai was. He was so down-to-earth and helped me understand everything that was happening to me. Every time I went, he encouraged me and was honest, but positive.
-Jen
Skin: Condition: Infomation Mohs Micrographic Surgery
This surgical procedure is used to treat more complex BCCs such as those present at difficult anatomical sites or recurrent BCCs. The procedure involves excision of the affected skin and examination of the skin removed under the microscope straight away to see if all of the BCC has been removed. If any residual BCC is left at the edge of the excision further skin is excised from that area and examined under the microscope and this process is continued until all of the BCC is removed. The site is then often closed with a skin graft. This is a time consuming process and is only undertaken when simple surgery may not be suitable.
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