The Skin Cancer Foundation recommends that everyone practice monthly head-to-toe self examination of their skin, so that they can find any new or changing lesions that might be cancerous or precancerous. Skin cancers found and removed early are almost always curable.
Dr. Daniel Mosel, dermatologist at Greater Nebraska Dermatology Clinic, and Dr. James Bunker, with Platte Valley Skin Clinic in North Platte, have offered free screenings for six years. Sponsored by Great Plains Health and other local businesses, the dermatologists alternate years for the annual May screening event.
“It’s a really nice service,” Mosel said. “The biggest thing is if there is something out of the ordinary for patients, anything that’s questionable, it needs to be examined.”
Mosel said people are always welcome to have anything unusual on their skin checked, whether it is at the free screening or any other time.
The dermatologists, Mosel said, follow the American Acedemy of Dermatology “ABCDE” criteria when checking for skin cancer.
That stands for:
» Asymmetry — if a mole looks asymmetric, that could be a concern.
» Border — it should have a sharp and regular border. If it’s irregular or ill-defined, that could be a problem.
» Color — If it’s multi-colored that could be concerning. If it’s a really dark color or a really red or pink color, that could be concerning.
» “D is diameter,” Mosel said. “That one’s easy — less that 6 millimeters you’re probably OK, bigger than 6 millimeters, maybe it needs to be checked.”
But one criteria stands out most to Mosel.
» “The most important one to me is the E, the evolution or change,” Mosel said. “If you have a mole that is changing rapidly, that could be concerning.”
80 people participated in the May 6 screening and the results varied.
“The most concerning would be melanoma,” Mosel said. “Melanoma has the highest risk of metastasis of the skin cancers on (the list from the screening) and it looks like we detected two melanomas at the skin screening.”
Mosel said early detection is vital.
“We want to catch them early,” Mosel said. “If we catch them early, melanoma is very curable.”
Patients are given two options at the screening event.
“They can have a full body skin exam,” Mosel said. “We have a special device called a dermatoscope that I use where I can look at certain lesions under a magnifier with tangential LED lighting. It helps us see into the skin, see blood vessels and see pigment underneath the skin.”
The other option for the skin screening is if people have just one spot or a couple of spots they want checked.
“We just check those spots and say, yes, they’re good or no, we should do something about these,” Mosel said. “We try to keep it comfortable for the patient.”
Mosel said the No. 1 cause of skin cancer is sun exposure, which he said is well documented.
“But there are other factors — genetics, skin type and medications can increase your risk of skin cancer,” Mosel said. “I think it’s multi-factorial, but sun exposure is No. 1 on that list.”
There are varying intensities of sun exposure.
“It falls under intermittent intense sun exposure, so that would include like weekend warriors getting sunburns here and there,” Mosel said. “But there is also chronic sun exposure, that outdoor worker that’s in the sun every day. Either one of those or both of them together can contribute to skin cancers.”
In addition, there are a number of classes and categories of medications that can potentially increase the risk of skin cancer, Mosel said.
“There are some antibiotics included in that, some of the blood pressure medications may potentially increase risk of skin cancer, although those studies have been retrospective,” Mosel said. “I wouldn’t say there have been any randomized controlled trials to date, but it is being studied further.”
Transplant patients whose medications have suppressed their immune system are also at a higher risk.
“Even some of our psoriasis medications they’re looking at as potentially increasing the risk of skin cancer, although slightly,” Mosel said.
Age can also be a factor.
“That is mostly due to sun exposure, but also due to something called immunosenescence,” Mosel said. “As we age, our immune systems aren’t as active as they used to be. The immune system plays a big role in the skin of oppressing and preventing skin cancer. So we think it’s two-fold.”
He said Caucasians have a higher rate of skin cancer “especially in your fair redheads and your fair blondes.”
“But even in Asian, Hispanic and African-American, skin cancer can occur,” Mosel said. “Interestingly in some cases, not in sun-exposed areas (of the body). It might be genetic or just bad luck.”
Great Plains Health promotes the event through its marketing, Pepsi donates drinks for the patients that are waiting in line, Runza donates cookies and Nebraskaland Bank grills hot dogs.
“It’s great to have all those commmunity sponsors helping us out,” Mosel said.