More than 200,000 people in Germany develop every year actinic keratoses, basal cell carcinoma, squamous cell carcinoma or melanoma. Skin cancer is the most common skin disease. White and black skin cancer can be treated well and safely. In order to detect skin cancer in an early stage and, if necessary, to treat on time, we recommend that you always have yourself examined with a dermoscope and digital dermoscopy including computer software (see digital skin cancer screening). Through the combination of our expertise and the use of the above mentioned tools, we achieve a significantly higher hit rate and can – if necessary – treat you in a timely, gentle and safe manner.
We recommend to perform a skin cancer screening based on your personal risk profile. In some cases, more frequent follow-up checks may be necessary. Since skin cancer can also occur at a young ager, sit is important to have regular skin cancer screening, especially if you have light skin, many birthmarks, a positive family history or do sunbathing on a regular basis.
By using photo-video-dermoscopy, digital recordings of suspect pigment moles can be made, analyzed with artificial intelligence (A.I.) and photo-documented for follow-up examinations.
The ABCDEF can help you with your self-examination:
A- Asymmetry – irregularly bordered or jagged shape of pigmented mark
B- Border- the edges of the mole are indistinctly defined or blurred
C- Color – an extra dark black coloring of the mole
D- Diameter– a diameter greater than 0.5cm
E- Evolution and Elevation– rapid growth of the mole and elevation above skin level
Q- Familial history– was there a melanoma in first degree relatives?
It should be mentioned that in the case of a melanoma all criteria can be present but also completely absent.
Actinic keratoses (precursors of white skin cancer) can develop as a result of recurring, brief and intensive sun exposure. This often affects – but not only – light skin types.
The affected areas are usually the parts of the body that are most exposed to the sun, such as the face, scalp, ears, neck, forearms and lower legs.If untreated, actinic keratosis can progress within 5-10 years or less to squamous cell carcinoma.
A particularly effective and gentle treatment option for actinic keratoses is laser treatment in combination with photodynamic therapy (PDT). Here, after previous laser treatment, the photosensitizer (5 aminolevulinic acid) is applied to the area to be treated. This is followed by irradiation with red light, which leads to a targeted destruction of the precancerous lesions (actinic keratoses) through a photochemical metabolism in the skin.
Pronounced findings may have to be surgically pretreated or even completely surgically removed.
Basal cell carcinoma
Basal cell carcinoma (BCC), also known as “white skin cancer”, is the most common skin cancer and affects around 100,000 patients in Germany each year. Risk factors include UV exposure as well as genetic disposition (skin type, gender, syndromes).
The basal cell carcinoma often grows in a locally invasive manner (limited to one area but progressing in depth). When diagnosing BCC, a full-body skin examination should be performed.
Dermoscopy can help to improve the reliability of the clinical diagnosis of BCC. Metastases of basal cell carcinoma are world widely an absolute rarity. Nevertheless, regular follow-up examinations are recommended after treatment. In the first 2 years after the removal of the basal cell carcinoma, the medical examination is carried out every 3 months. After 2 years, follow-up is every 6 months.
Squamous cell carcinoma (Spinaliom)
Spinalioma is a malignant form of white skin cancer. A major risk factor is recurring, intense exposure to the sun. The skin change usually occurs from the age of 60, occasionally there may be some exceptions.
Most affected are heavily exposed areas to sun light, such as the head or the extremities. The main danger is its rapid growth and the tendency to form metastases via the lymphatic and bloodstream.
For this reason, squamous cell carcinomas must be excised and histologically examined (3-D histology). The follow-up examination is carried out in the first 2 years after the removal of the spinalioma in patients with a low to medium risk of metastasis every 6 months or in patients with a high risk every 3 months (AWMF guideline; as of March 2020).
This allows any recurrences of the tumor to be detected and treated at an early stage.If there are no recurrences in the first two years after the surgery , the follow-up examination is perforemd annually (low risk of metastasis) or every 6 months (high risk of metastasis).In the case of particularly thick squamous cell carcinomas (more than 6mm), regular ultrasound examinations of the draining lymphatics are also carried out.After four years, further check-ups are carried out depending on the findings or at least every two years.
Black skin cancer is the most dangerous type of skin cancer. The tumor originates from the black pigment cells (melanocytes) and can arise either de novo (new) or from pre-existing birthmarks.
In Germany, around 30,000 people are affected each year. If left untreated, melanoma can spread through the body via the lymphatic system or blood vessels.
After surgery, it is important to have regular follow-up examinations. Irrespective of the follow-up examination, it is important that you also examine yourself carefully and regularly for noticeable skin changes and feel the lymph node stations.
Follow-up examination for melanoma (excerpt from the AWMF melanoma guideline; as of July 2020):