Skin cancer is the 6th most common cancer in Singapore. As in the case of all suspected cancers, early detection is crucial for a positive prognosis. Are you searching for a skin cancer dermatologist in Singapore? Dr. Teo Wan Lin is an expert skin cancer dermatologist in Singapore who performs mole screenings, diagnosis of skin cancers and surgical treatment. She has published on the topic of skin cancers, including a first author publication on T-cell lymphomas in the prestigious Journal of Clinical Oncology and on morpheaform basal cell cancers in the International Journal of Dermatology.
The basics of skin cancer
There are two main types of cancers that occur on the skin. The first is what we term as malignant melanoma, and the second category would be non melanoma skin cancers.
We’re gonna start with the diagnosis of a skin cancer. The two main types of skin cancers can be distinguished primarily by the presence of pigment, specifically melanocytes. Melanocytes are the cells that produce pigment and appear commonly as what we describe as moles. When a skin cancer arises from a mole known as melanocytic naevus, it has the potential to be a melanoma.
What are the warning signs of a mole that is cancerous?
We use the acronym ABCDE, which stands for the following A for asymmetry B for borders C for two different colors and D represents diameter. So, a mole that is larger than 6 millimeters large in diameter
is more suspicious than one that is smaller than that. Lastly, E for evolution, meaning if an existing mole changes or evolves, either by becoming itchy, if it bleeds, if there is a sudden increase in size or if the mole or part of it disappears. Now these are warning signs.
Non-melanoma skin cancers
Moving on to non-melanoma skin cancers. Now, these are actually the more common type of skin cancers in Asia, and can be further divided into the following the basal cell cancers and the squamous cell cancers. These two types of cancers are distinguished based on The origin of the cancer, whether they come from the basal layer of cells, or whether they arise from the superficial layer known as the keratinocyte layer.
The key thing about non-melanoma skin cancers, is that the prognosis is generally good, as long as one gets diagnosed and treated early. Diagnosis is via clinical examination and may require biopsy.
If you have a family member who has had a skin cancer before you are considered at higher risk than the general population. Especially if you develop a mole, or a new growth that seems to be changing. If you have not noticed it before and you have suddenly noticed it, it may be time to get evaluated by an accredited skin cancer dermatologist.
What does a skin cancer dermatologist do in the context of management?
First of all, if you have a suspicious growth, it is important to rule out the diagnosis of a skin cancer, which, in the context of this article can be either melanoma, or non melanoma skin cancer. Most moles, however, are not melanoma. They may appear atypical, meaning slightly different from your regular most because they present with features of dysplasia. Dysplastic moles can have irregular borders, multiple colors and can be fairly large as well.
An accredited skin cancer dermatologist who specializes in the treatment of skin cancers will be able to diagnose a melanoma or a dysplastic mole using tools such as clinical examination, dermoscopy. If necessary, your skin cancer specialist will suggest a biopsy.
The most important thing to note is this. If you have a diagnosis of a dysplastic mole, which is a histological diagnosis, you are on the average at higher risk of acquiring melanoma in your entire lifetime, compared to an individual who does not have the diagnosis.
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Diagnosis of melanoma
The good news is that early stage melanoma can be effectively cured with surgical acquisition, as long as there is no lymph node or organ involvement. However, the danger is a lot of moles may be hidden, such as on the buttock area or on the soles of your feet, which is not easily self-monitored. When you may discover that a mole has been growing there for some time, it may be a little late.
If a mole has any of atypical features, it needs to be diagnosed promptly. For the treatment of non-melanoma skin cancers, the prognosis is generally good as long as the diagnosis is made early. The problem with non melanoma skin cancers is that when it’s diagnosed and treated late, there is significant morbidity. Realistically, it leaves a larger surgical scar, there may be a lot more tissue loss, as opposed to if it were diagnosed in the early stage and removed at that time.
Basal cell cancers
Some of the characteristic diagnostic features of basal cell cancers would be a pearly pink or pearly white nodule or papule, located on any part of your body. The face is one of the commonest areas. A basal cell cancer when closely examined shows signs of increased blood vessels from the surface, also known as telangiectasia.
Squamous cell cancers
For squamous cell cancers, a lot of these look like bumps, where there is excessive dead skin. Some individuals who have had significant amount of sun exposure in their lifetime may develop several precancerous growth known as actinic keratosis. Actinic keratosis are not squamous cell cancers
but must also be treated in order to prevent transformation into squamous cell cancers.
Actinic keratosis can be treated with liquid nitrogen, as well as surgical excision, if there is suspicion of transformation to squamous cell cancers.
Are you looking for an experienced skin cancer dermatologist in Singapore? Book for a consultation with Dr. Teo Wan Lin, an accredited dermatologist with our online booking tool here.
Teo WL, Tan SY. Loss of Epstein-Barr virus-encoded RNA expression in cutaneous dissemination of natural killer/T-cell lymphoma. J Clin Oncol. 2011 Apr 20;29(12):e342-3. doi: 10.1200/JCO.2010.31.4096. Epub 2011 Jan 31. PMID: 21282547.
Teo WL, Wong CH, Song C. Morpheaform facial basal cell carcinoma – a 16-year experience in an Asian center. Int J Dermatol. 2012 Nov;51(11):1396-8. doi: 10.1111/j.1365-4632.2010.04767.x. Epub 2011 Dec 16. PMID: 22171721.