Do you know what symptoms patients with mid- to late-stage skin tumors often have?

Skin cancer is a malignant disease based on skin cell changes. The early symptoms are usually redness, itching, white spots, or eczema-like masses. Because they are not specific, they do not attract the attention of patients. Let our experts briefly introduce the symptoms of patients with mid-to-late stage skin tumors, hoping to help you!

Symptoms of patients with mid- to late-stage skin tumors:

(1) Basal cell carcinoma

It is common in people aged 50 to 60, with slightly more cases in men than in women. The most common sites are exposed areas with thin epidermis and rich sebaceous glands and often exposed to sunlight, such as the wings of the nose, inner and outer canthi, forehead, temples, neck, etc. About 10% of cases occur on the trunk. In the early stage, basal cell carcinoma is a small nodule of light yellow or pink color slightly higher than the skin surface, with a smooth surface, accompanied by dilated capillaries, hard texture, and often no pain or tenderness. If the lesion is located in a deeper surface, after a long period of development, scaly desquamation will appear on the surface, followed by repeated scabs and desquamation, and erosion and bleeding on the surface.

As the lesion continues to grow, a superficial ulcer forms in the center with jagged edges that resemble worm-eaten areas. Some basal cell carcinomas are accompanied by melanin deposition. These small dots of pigment spread throughout the lesion and fuse together to appear brown, black, or blue. This is called pigmented basal cell carcinoma, which is easily confused with malignant melanoma. However, it can be distinguished from melanoma based on its long course, slow development, and often no regional lymph node metastasis.

When it is difficult to distinguish clinically, a biopsy should be performed to confirm the diagnosis. On the other hand, a relatively rare morphea-like basal cell carcinoma presents as a smooth fibrous plaque-like lesion that resembles scar tissue. There are no obvious changes such as telangiectasia, ulcers or bulges on the surface, but the boundaries are very unclear; lesions on the trunk are more common than on the head and neck, and are often widely infiltrated when diagnosed. Fortunately, this type is very rare. Basal cell carcinoma develops slowly and mainly presents local invasive growth. Basal cell carcinoma occurring in the nose and auricle can infiltrate and destroy cartilage, and those occurring on the scalp can corrode the skull and involve the dura mater.

(2) Squamous cell carcinoma

Early squamous cell carcinoma is similar to basal cell carcinoma, generally presenting as erythematous skin lesions with varying degrees of scaly desquamation and crust formation, which are often difficult to distinguish clinically. However, squamous cell carcinoma often develops on the basis of lesions such as senile hyperkeratosis, chronic ulcers, and burn scars, and manifests as red, hard, and elevated nodules. When the surface keratin layer falls off, it can heal and form a scab, but soon the scab falls off and an erosive surface appears, accompanied by exudate and bleeding. At first, the erosive surface can heal and form a scab, but soon the scab falls off and infiltrates deeper, forming an ulcer with a slightly raised edge, an uneven base, and a red granular shape, often accompanied by necrotic tissue and granulomatous hyperplasia. The tumor is brittle, and secondary infection is often accompanied by foul-smelling secretions.

Experts said that some squamous cell carcinomas grow rapidly and protrude from the skin surface, presenting as typical cauliflower-like masses. Some present as mushroom-like or warty protrusions, with no ulcers on the surface, which are called papillary squamous cell carcinomas. Compared with basal cell carcinoma, squamous cell carcinoma develops faster and is easy to metastasize to regional lymph nodes. Its metastasis rate varies with the location of the lesion. About 5% of squamous cell carcinomas of the head and face metastasize to the preauricular, postauricular and cervical lymph nodes. The metastasis rate of squamous cell carcinomas on the back of the hand is about 20%, and the metastasis rate of inguinal lymph nodes in the lower limbs is about 33%. Hematogenous metastasis is rare, and the lungs are the most common site of metastasis.

(3) Carcinoma in situ

Bowen first described this disease in 1912, so it is also called Bowen's disease. Some scholars reported that this disease is more common in people aged 60 to 70, with a male-female ratio of 0.8 to 1.2:1. The most common site is the head and neck, accounting for 44% to 54%. It can also occur in the hands, trunk, buttocks, anus and genital mucosa, oral mucosa and nail bed.

About 72% of cases occur in sun-exposed areas. Most of them are single, but there may be 2 to 3 lesions. They appear as light red or dark red slightly raised lesions with many desquamations and crusts on the surface. The lesions gradually expand into round or annular papules with clear edges, covered with thick brown or gray crusts that are not easy to fall off. If forcibly peeled off, a fine granular or papillary moist surface will be revealed, with slight local tingling.

The course of the disease progresses slowly and can last for 5 to 35 years. Ulcers rarely occur, but 20% to 30% may develop into invasive cancer, and about 20% may metastasize to regional lymph nodes. The prognosis of skin carcinoma in situ combined with cancers of other organs is poor.

Do you know the symptoms of patients with mid- to late-stage skin tumors that the experts briefly introduced above? If you have any questions, please consult our online experts, and we will serve you sincerely! I wish you a speedy recovery!

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