The skin and subcutaneous tissue are prone to develop various tumors of different size and behavioral characteristics during lifetime. These changes are most commonly benign. The treatment of skin tumors largely depends upon their characteristics. Some are removed for purely esthetic reasons, especially if they are on the face, while others belong to the group of tumors that requires surgical excision (a biopsy).
Moles belong to a group of efflorescences in darker pigmented skin. They appear at birth or develop during lifetime. During lifetime, moles either maintain their size or grow proportionally with the region where they are located. They may vary in size, may be leveled with the skin or above the skin level, and may be attached to the skin surface by a tiny stalk. The surface of a mole can be smooth or wrinkled. They usually occur on the face, neck and chest. Moles are benign in their nature, but their mechanical irritation or microtrauma can involve a special risk for the development of a malignant change.
A malignant change must always be suspected if any of the following changes suddenly occur in a mole which remained unchanged for years, including changes in pigmentation, asymmetry, change in color or size, and bleeding.
However, it cannot be determined with certainty which moles will develop into malignant growths, so they should be followed up. Solarium exposure and overexposure to sunlight over the summer months are associated with the development of malignant tumors later in life. The latter is especially due to ozone depletion resulting in enhanced ultraviolet radiation reaching the Earth’s surface.
Skin HPV infections (warts)
Some types of HPV can cause skin warts. The disease has spread worldwide, and it is most common in children and adolescents. Warts can occur single or in clusters, and according to their appearance they can grouped as follows:
- verrucae vulgares (common warts) – hard lesions, raised above the skin level, 1 cm in size, brown or skin-colored, usually appearing on the hands and fingers
- verruce plantares (plantar warts)– appearing on the thick skin and pressure-exposed areas (i.e. the soles of the feet, toes)
- verrucae planae juvenilis (flat or juvenile warts) – flat, slightly raised above the skin level, skin-colored, light brown or grayish, usually appearing on the face and hands
- verrucae filiformes (filiform warts) – found on the neck, face, and especially on the eyelids, mouth and nose
Malignant changes
Overexposure to sunlight causes damage on the level of DNA, which can promote the development of precancerous skin lesions and skin cancer. The most common skin cancers (the so-called non-melanoma carcinoma) are basocellular and planocellular carcinomas, of which more than 90% are caused by sun exposure. Basocellular carcinoma of the skin develops on an unchanged skin, while planocellular carcinoma develops from a precancerous lesion, i.e. actinic keratosis. Skin cancer is clinically characterized as the occurrence of “a long-lasting ulcer that does not heal”.
It should be pointed out that a close association has been demonstrated between the effects of UV radiation and the development of malignant melanoma, especially in persons of fair complexion and numerous pigmented lesions (skin damage). Another risk to be stressed out is the risk of the so-called recreation sunbathing, relating to intense, intermittent exposure to sunlight for relatively short periods, usually during short holidays, aimed at getting ‘a dark tan’ as soon as possible.
