FACIAL SKIN LESIONS (CANCER AND NON CANCERS)

A facial skin lesion could be a lump, crack, ulcer or abnormal discoloration of the skin that is not normally present. A lesion is described as benign when it is harmless. It is described as malignant when it is a sign of cancer and is potentially dangerous. You should seek medical advice if you notice changes in a facial skin lesion, these include: Skin sores that do not heal, Bumps or nodules in the skin that are enlarging, an increase in size shape or colour of a lesion, persistent itching, ulceration, or bleeding.

Common benign facial skin lesions:

Naevi or skin moles. These are often darker than the surrounding skin (e.g. brown or brown-black) because they contain more pigment (colour). Rarely, some moles can develop into malignant melanoma especially when they are exposed to a lot of sun.

Papillomas are wart-like benign skin swellings.

Fibromas are raised swellings that are seen in association with chronic trauma.

A lentigo is an area of skin that contains an increased number of pigment cells. This differs from a freckle in which the number of melanocytes is normal, but the amount of pigment that they produce is increased more than in adjacent skin after sunlight exposure. There are several different types of lentigo.

Seborrhoeic keratosis is also known as senile keratosis because they usually occur in older people. They may be flat, raised or pedunculated (on a stalk) .They are usually yellow to dark brown in colour, and can be described as a greasy scaling.

Actinic (Solar) Keratosis is a direct result of decades of accumulated sun damage. Actinic Keratosis usually develops on the face, lips, ears, scalp, neck, forearms, the areas most commonly exposed to the sun. They appear in the over 40 age group. There is a small risk of malignant transformation. Actinic keratoses are scaly, rough, reddish-brown or yellowish spots on sun-exposed skin of the face and body.They are considered pre-cancerous lesions. Fortunately these lesions can easily be treated in a number of ways.

Lentigo Maligna is a form of ‘in situ’ melanoma that usually occurs on the face in elderly people. It is typically a very slowly enlarging patch without any thickening, but with variation in its colour (usually medium brown but with darker brown or black areas). Sometimes, often after many years, a lentigo maligna may form a true invasive melanoma, which is then termed Lentigo Maligna Melanoma.

Common malignant facial skin lesions:

Basal cell carcinoma or ‘rodent ulcer’ is the commonest skin cancer and usually occurs as a result of sun damage. Basal cell carcinoma are slow growing and are locally destructive however they do not spread to other parts of the body. They are commonly found on the face.
Early tumours may be indistinct but may appear as red scaly patches, pearly nodules or as an ulcer.
Basal cell carcinoma are neither life threatening or trivial. The importance of adequate treatment and close follow up cannot be overstated. However, they can be very destructive, penetrating to muscle, cartilage or bone depending on the site, if they are left untreated.

Squamous cell carcinoma (SCC) is the Second most common skin cancer.
SCC can arise in sun damaged skin or normal skin and appears as keratotic nodule with ulcerated centre. SCC has a potential to spread to lymph glands making it potentially dangerous. It is commonly found on the face.

Malignant melanoma is a cancer that begins in the pigmented cell in the skin. They are often brown or black in colour. It can spread quickly to other parts of the body. Melanoma is much less common than basal cell and squamous cell skin cancers, but it is a much more aggressive cancer and its consequences are far more serious. Fortunately, most melanomas have a very high cure rate when identified and treated early.Early detection is most important. The earliest sign of melanoma is the change in size, shape, or colour of a mole or spot on the skin. The earliest symptom, although most don’t have it, is persistent itching for no apparent reason. Therefore, any mole or spot on the skin which is changing in size, shape, or colour or is persistently itching, especially in a person at risk for melanoma, will usually need to be seen by a health care professional and possibly tested.