Actinic Keratoses (AK) are potential precancerous skin lesions. They occur as a consequence of cumulative low-grade sun exposure over many years.

Actinic Keratoses form not just from intentional suntanning but from every day casual sunshine such as walking to and from your car, a brief stroll with your dog, a walk with friends through the neighborhood, and even exposure to the sun through the windows in your car.

Actinic Keratoses can occur anywhere on the body, however, they are most commonly found on the face, neck, forearms, backs of the hand, any other sun-exposed parts of the body.

AKs look like a patch of dry skin, and treatment of AKs is necessary as they commonly transform into squamous cell carcinoma.

The treatment options are varied but include liquid nitrogen, surgical excision, topical medications (5-fluorouracil, imiquimod) as well as medium-deep skin peels using trichloroacetic acid, and photodynamic therapy.

If you think you may have Actinic Keratoses, we strongly recommend that you schedule an appointment with Dr. Alanen immediately.

Basal Cell Carcinoma (BCC) is the most common type of cancer found in humans. It occurs most often on the face, neck, arms, and hands. As with Squamous Cell Carcinoma (SCC), the most important risk factor for Basal Cell Carcinoma is years of exposure to ultraviolet light.

Although not necessarily directly related to the use of tanning beds, tanning beds in conjunction with a history of phototherapy for psoriasis are considered significant risk factors for Basal Cell Carcinoma.

BCC most often looks like a “non-healing sore” or persistent pimple. However, in some cases, it may resemble a scar.

Treatment

Basal Cell Carcinoma is best treated by surgical removal.

Dr. Alanen’s Expertise

The microscopic examination and diagnosis part of the procedure is often regarded in the dermatology community as the most difficult part of the procedure. However, Dr. Alanen is a recognized subspecialist in microscopic diagnosis of skin cancer.

Squamous Cell Carcinoma (SCC) is the second most common type of skin cancer in humans. It typically develops on sun-exposed areas of the body, including the face, ears, lips, hands, arms, and legs. Like Basal Cell Carcinoma (BCC), the primary risk factor for Squamous Cell Carcinoma is cumulative ultraviolet light exposure over many years.

Additional risk factors include a history of severe sunburns, fair skin, immunosuppression, and exposure to certain chemicals or radiation. Individuals with a history of actinic keratoses (precancerous skin lesions) are also at increased risk for developing SCC.

SCC commonly appears as a firm, red nodule or a flat lesion with a scaly, crusted surface. It may also present as an open sore that doesn't heal, or a wart-like growth. Unlike BCC, SCC has the potential to spread to other parts of the body if left untreated, making early detection and treatment crucial.

Treatment

Squamous Cell Carcinoma is most effectively treated through surgical removal. For many SCCs, Mohs' micrographic surgery (MMS) is the preferred treatment method, particularly for lesions in cosmetically sensitive areas or those with aggressive features.

Mohs' Micrographic Surgery combines precise surgical technique with immediate microscopic examination of the removed tissue. The procedure involves systematically removing thin layers of cancerous tissue and examining each layer under a microscope while the patient remains in the clinic. The process continues until no cancer cells are detected, ensuring complete removal while preserving as much healthy tissue as possible.

Dr. Alanen's Expertise

The microscopic interpretation component of Mohs' surgery requires extensive specialized training and is considered one of the most challenging aspects of the procedure. Dr. Alanen's recognized expertise as a subspecialist in the microscopic diagnosis of skin cancer ensures accurate identification and complete removal of SCC while minimizing the risk of recurrence.

Dysplastic Nevi, also referred to as atypical moles or atypical nevi, are potential precursors of malignant melanoma, the most aggressive form of skin cancer.

Only a small proportion of dysplastic nevi transform into melanoma The higher the number of these moles someone has, the higher the risk; those who have 10 or more have 12 times the risk of developing melanoma as compared with the general population.

Medical reports indicate that about 2 to 8 percent of the Caucasian population have these moles. At times it is difficult to distinguish dysplastic nevi and early melanomas.

Often, a handheld magnification device called a dermatoscope is used. When concerning features are noted, the mole is removed so that it can be examined under the microscope and the definitive diagnosis can be established.

Patients with numerous dysplastic nevi are at high risk of developing malignant melanoma. Mole mapping technology allows for early melanoma detection; read more here.

If you have a concerning mole, please book an appointment.

Melanoma is much less common than some other types of skin cancers. But melanoma is more dangerous because it’s much more likely to spread to other parts of the body if not caught and treated early.

Malignant melanoma is the most serious type of skin cancer. It may start from a mole or arise on normal skin. If melanoma is detected early, it is classically curable. However, if melanoma spreads from the skin to lymph glands and other organs, it is often fatal.

The risk factors for melanoma include: fair skin, reddish hair, numerous moles, numerous freckles, a history of sunburns (particularly in youth), a personal or family history of numerous atypical (dysplastic) moles.

The A, B, C, D, E, Identification Approach

To help you identify characteristics of unusual moles that may indicate melanomas or other skin cancers, think of the letters A-B-C-D-E:

A. is for asymmetrical shape. Look for moles with irregular shapes, such as two very different-looking halves.

B. is for irregular border. Look for moles with irregular, notched or scalloped borders characteristics of melanomas.

C. is for changes in color. Look for growths that have many colors or an uneven distribution of color.

D. is for diameter. Look for new growth in a mole larger than 1/4 inch (about 6 millimeters).

E. is for evolving. Look for changes over time, such as a mole that grows in size or that changes color or shape. Moles may also evolve to develop new signs and symptoms, such as new itchiness or bleeding.