Understanding Squamous Cell Carcinoma
I’ve got yellow growths on my eyelids. What should I do?
I was told I had cholesterol deposits on the inside corners of my eyelids. Once I had them removed surgically, but they returned. I changed to a low-cholesterol diet years ago. What can I do to get rid of them?
These represent minor collections of oil below the surface of the eyelid skin. This is called xanthelasma, which is derived from a Greek word meaning “yellow plates.” In certain individuals, this reflects high levels of fats in the blood (cholesterol and/or triglycerides). If you have these, you should have your laboratory tests done to detect your lipid levels. If you have high blood fat levels, this can be treated and lower your susceptibility to heart attacks in the future. If you want these removed, there are many alternatives, including the application of dilute trichloroacetic acid or electrosurgery.
What are actinic keratoses?
My doctor said I that had them and prescribed a cream to get rid of them.These are also called solar keratoses and are the dry, rough, and scaly lesions in sun-exposed areas. They usually are not too bothersome, although some may become irritated and cause some discomfort. A certain percentage of the crop may evolve into squamous cell carcinoma, and that is why it is important to treat them. Treatment includes cryotherapy, retinoids, laser, chemical peels, and fluorouracil (5-FU, a cancer-treating drug). The 5-FU in products such as Efudex® has been the mainstay of treatment for many years.
A friend of mine said he got spots “frozen.” What does that mean?
Cryosurgery or cryotherapy (liquid nitrogen spray) is used frequently by dermatologists to treat many skin problems, including scars, growths, keloids, precancers, and some skin cancers. The light freezing causes a peeling, while moderate freezing may result in a blister.
We use it most commonly to treat actinic keratoses (precancers), and it is often combined with other modalities such as 5-fluorouracil (Efudex) to rid the skin of these lesions.
I am Black, and I get razor bumps. I’m tired of them but can’t seem to get rid of them. Do you have any suggestions?
Pseudofolliculitis barbae (razor bumps) occurs in up to 60% of Black men and other people with curly hair. In this condition, highly curved hairs grow back into the skin and cause inflammation and a foreign body reaction. Keloidal scarring and hard bumps can occur on the beard area and neck. Shaving may sharpen the ends of the hairs like spears and aggravate the skin.
The only 100% effective treatment is to let the beard grow. After growing to a certain length, the hairs will not grow back into the skin. Avoid shaving for 3 to 4 weeks, and apply a mild prescription cortisone cream to decrease the inflammation. If you need to shave, do it every other day to improve pseudofolliculitis barbae. Before shaving with a blade, water softens the beard first with a hot, wet washcloth for 5 minutes. Preshave solutions can help soften the hairs and lubricating shaving gel (Edge®, Aveeno), or prescription-medicated shaving foam (BenzaShave® by Dermik) will often help. Use only one stroke over each area of the beard. Shave with the grain of the beard, and do not stretch the skin. Switching to an electric shaver may also help because it does not cut as close as blades do. Prepare the beard with electric razor preshave, and use the high setting to avoid close shaving.
Consider electrolysis and laser hair removal when all else fails. This can be expensive and take repeated visits, and there is a small risk of scarring. A few insurance companies will cover some or all of the cost. Medications are also prescribed to speed healing of the skin, including glycolic acid lotion, prescription antibiotic gels (Benzamycin®, Cleocin T®), oral antibiotics, and nightly Retin-A.
I’ve got ulcers on my legs. What can I do?
First you have to find out what kind of wound you have-vascular, diabetic, or traumatic-and then take the correct path to healing. Hundreds of different remedies are available for ulcers and wounds. If you have not had a culture (swab) of the wound or biopsy, I would advise it to help make sure you have the proper diagnosis. I have seen many patients treated for a routine wound who actually have lupus or a skin cancer or other problem. Adhesive films can be applied to the surface of the ulcer with a so-called semipermeable membrane that allows oxygen to pass into the healing area. Moisture is held inside to promote faster healing. Wound gels, debridement, irrigation, and other treatment modalities may also be used depending on the stage and depth of the wound.
Chronic ulcers are a very expensive and bothersome problem. Smoking, poor nutrition, and a lack of exercise also contribute to poor wound healing. I recommend lifestyle changes as needed and referral to a dermatologist or wound care center if you have one available.
Chronic ulcers are a very expensive and bothersome problem.
Smoking, poor nutrition, and a lack of exercise also contribute to poor wound healing.
Terms:
Squamous cell carcinoma – Squamous cell carcinoma is the second most common cancer of the skin and occurs most commonly in middle-aged and elderly people with fair complexions and frequent sun exposure.
Cryosurgery – Used frequently by dermatologists to treat many skin problems. Liquid nitrogen is sprayed on to an area of skin, thus freezing it.
Keloids – The increase in collagen growth under normal scar tissue.
Inflammation – The result of the immune system reacting to unwanted stimulation.
I have spots on my penis. Is it syphilis?
You may have red spots on your penis that are not sexually transmitted. Psoriasis is not uncommon in this area. Certain skin cancers such as squamous cell carcinoma, as well as other noncontagious skin diseases, may also be seen. If a penile lesion persists, get it checked. Syphilis is a sexually transmitted infection caused by a spirochete Treponema pallidum. Syphilis is known as the great imitator because of its varying clinical signs and symptoms. Infection is characterized by episodes of active disease (primary, secondary, and tertiary) with intervening latent periods. Tertiary syphilis can develop 5 to 20 years after the first exposure and may affect other body systems, such as the brain, blood vessels, and eyes.
If you are concerned that you may have been infected or have symptoms, a blood test that uses antigens can be performed. A doctor may also choose to perform a biopsy of an ulcer or irritated area to distinguish syphilis from other diseases. Penicillin G is the treatment of choice for a patient with syphilis. If you have penicillin allergy, tetracycline, erythromycin, or ceftriaxone can be used as alternative treatments. While being tested, you also need to be examined for other sexually transmitted infections, including HIV, hepatitis, and chlamydia. Prevention requires safe sex practices.
I’ve had a raised area where I had acne on my chest. It has been there for 20 years. Is there anything I can do?
Keloids are the raised and often reddish nodules that develop at the site of an injury when skin cells and connective tissue cells (fibroblasts) begin multiplying to repair the damage. The fibroblasts continue to multiply even after the wound is filled and project above the surface of the skin-keloids. The upper chest, shoulders, and upper back are especially prone to keloid formation. Although there may be no symptoms, itchiness, redness, unusual sensations, and pain may occur. Keloids occur in about 10% of people. Men and women are equally affected, but darkly pigmented people seem to be more prone to forming keloids. A hypertrophic scar looks like a keloid. Hypertrophic scars are more common and don’t get as big as keloids; they may fade with time. Although keloids are considered a benign tumor, they can be a significant cosmetic nuisance. Although there is not a single cure for keloids, treatments include cryosurgery (freezing), excision, laser, x-rays, and steroid injections.
Injection of long-acting cortisone (steroid) into the keloid once a month is usually the first choice, even if the keloid has been on the skin for many years. After several injections, the keloid may become less prominent in 3 to 6 months of time. If they are surgically removed, recurrences are common.
