Staying healthy is what it's all about!

Stephen L. Blythe, D.O.

Board Certified, Family Practice


Machias, Maine 04654

Skin Cancer

Skin cancer affects hundreds of thousands of Americans yearly. Melanoma, a particularly deadly form of skin cancer, kills almost ten thousand every year. The sad thing is that skin cancer, because it is visible, can be detected very early when treatment is easy and effective.

What does skin cancer look like?

Skin cancer is divided into two basic types - melanoma, and "non-melanoma". Melanomas are cancers of the pigment-forming cells and are generally darkly pigmented (there are rare exceptions). These tend to be the "mole that is changing". Non-melanoma skin cancers include basal cell cancer and squamous cell cancer. These tend to form sores that don't heal. They may be flat, raised, crusty, bleeding, itchy, red, or simply a raised area on the skin that looks like a mole. Any skin lesions that are new or changing in appearance or texture should be evaluated.


Melanomas can occur anywhere on the body.  Although fair-skinned people are at higher risk, as are those who have had bad sunburns when younger, melanomas are not necessarily triggered by sun damage. They can appear on the scalp, on the bottom of the foot, under a fingernail, or on your behind.  What are the indicators that it might be a melanoma? We talk about the A,B,C,D,'s of melanoma - it tends to be:

  • asymmetrical - not round or oval
  • border is irregular, may have smaller separate areas adjacent
  • color is very dark and/or multiple colors are present
  • diameter is larger than that of a pencil eraser 

Some people add an "E" - it is evolving - it is changing, either in size, color, or texture.  Any skin lesion that meets even a few of these criteria needs to be evaluated. It is very simple to take a small punch of skin (a biopsy) to test. Below are some photographs of melanomas:




Because melanoma is so deadly, it is useful to do a TSSE - a Thorough Self Skin Examination - once monthly. You can alternatively share this task with your spouse.  You need to inspect ALL of your skin, and document any areas of concern and review those with your physician.

Basal Cell and Squamous Cell Cancers

These cancers start with sun damage, and so are more commonly seen on sun-exposed areas such as the face, hands, ears, and back. Fair-skinned people (red-heads especially) are most at risk. Early pre-cancerous changes may result in scaly patches of skin - these can be treated with medicated creams or liquid nitrogen before they become cancerous. Once they turn into cancers, more aggressive treatment such as surgery or even radiation may be required. These cancers if left untreated may eventually spread, but they do not tend to be as deadly as melanoma. This ulcerated lesion on the nose is a very typical basal cell cancer:

Basal Cell Skin Cancer (c) James Heilman, MD

Basal and squamous cell cancers may form nodules:

Basal cell cancer

 or they may be just in the top layer of skin, forming superficial cancers:

Skin cancer

Some squamous cancers will become crusty:

Crusty Skin Cancer

Skin Cancer

These lesions may be confused for psoriasis or other problems - or they may be psoriasis. If you have any question about your skin, please see your doctor as soon as possible!