By Premier Foot & Ankle Specialists
With summer quickly approaching, many people will be spending more time outside while wearing sandals and open-toed shoes, and will invariably be subjected to increased sun exposure. Skin cancer is the most commonly diagnosed cancer in the United States, and over 5 million new diagnoses are made every year, according to the Centers for Disease Control and Prevention. It is commonly believed that prolonged sun exposure is the sole cause of skin cancer formations, however, chronic inflammation, viruses, chemical exposure, or inherited traits can also be commons causes, along with prolonged unprotected UV exposure. Skin cancer can develop almost anywhere on the body, including the lower extremities and feet, which can often be overlooked on regular medical physical examinations. So, what are the most common cancers found in the feet and associated signs and symptoms to look out for during an evaluation?
Basal cell carcinoma is most commonly seen on sun-exposed surfaces of the skin, and is less commonly found on the feet, due to being less exposed to the sun. This type of skin cancer is one of the least aggressive cancers, and typically remains confined to the area of skin involvement, and rarely spreads to other tissues of the body. Physical characteristics of basal cell carcinoma are pearly white patches or bumps with overlying crusts that can ooze, with the appearance of an open sore, that can often resemble ulcerations and non-cancerous lesions when encountered on the legs and feet.
Squamous cell carcinoma is the most common form of skin cancer to be found on the feet, and typically remains localized to the skin with limited potential for spread. However, in more advanced later stages, squamous cell can develop the potential to become more aggressive and spread to other tissues of the body. Physical characteristics can include small scaling bumps or calluses on the skin with recurrent cracking, inflammation, or bleeding, which are typically painless. Squamous cell carcinoma can also resemble other benign skin conditions of the foot, including eczema, ulcers, plantar warts, or fungal infections.
Malignant melanoma is one of the deadliest types of skin cancer, and early detection is critical in optimizing patient survival. Melanoma can occur on a number of surfaces of the feet, including the soles, tops of feet, and underneath a toenail. Melanoma is an aggressive form of cancer, and can extended into the deeper levels of skin and spread through lymphatic and blood vessels. Malignant melanoma has a variety of appearances, which can include small brown-black bumps on the skin, with some lesions lacking brown pigmentation, and appearing red or pink. On first inspection, melanoma might appear similar to moles commonly seen on the body, however, they usually feature asymmetry, irregular borders, variable coloration, and diameter greater than 6mm. They commonly resemble other types of benign lesions of the skin including moles, plantar warts, ulcers, foreign bodies, or even ingrown nails.
It is important to inspect your feet and check your skin regularly for any abnormal looking moles or lesions of the skin. Early detection of skin cancers is critical for treatments. When evaluating for melanoma specifically, utilizing the ABCDs of melanoma:
Asymmetry: the lesion divided in half appears to have two differently-shaped sides that do not match.
Borders: the borders are not clearly defined, and have ragged, uneven, or “scalloped” edges.
Color: there is more than one color that varies within the lesion and is unevenly distributed.
Diameter: the lesion is greater than the size of a pencil eraser (greater than 6mm).
If you believe you have melanoma, based on any of the above factors, you should contact your podiatrist immediately for further evaluation and treatment. Your podiatrist can investigate for the presence of skin cancer through a thorough clinical examination, and also perform a skin biopsy if indicated. A skin biopsy is a simple in-office procedure, where a small sample of affected tissue is obtained and submitted to a specialized pathology laboratory to evaluate the tissue and detect any forms of cancer. If the results are positive for cancer, your podiatrist will recommend an appropriate treatment course.
Summer is always an enjoyable time to spend outdoors, as long as one takes steps to protect your skin. It is important to limit direct ultraviolet radiation from the sun, especially during peak daytime hours. Wearing sun-protective clothing and shoes is optimal. Applying sunscreen to exposed areas of skin including your feet is also essential. Inspecting the bottoms and tops of your feet, in between your toes, and under your toenails is also prudent. If you notice any skin lesions suspicious or concerning, similar to those seen above, contact your local podiatrist for evaluation. Dr. Roggow and Dr. Bonjorno are happily taking new patients and look forward to meeting you!
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4120 Woodmere Park Blvd, Suite 5, Venice, FL 34293