Common skin cancers in the United States: a practical guide for diagnosis and treatment

Cutaneous malignancies are the most common cancers found in the primary care setting. It is imperative that all primary care providers become competent in evaluating skin lesions. Actinic keratoses are the most common premalignant lesions. These rough scaly plaques are the direct result of ultraviolet and other carcinogenic exposure. Actinic keratoses may be the first clinical sign to alert primary care practitioners of severe solar dermatitis and herald the development of skin cancer. Treatment is cryotherapy or topical chemotherapeutic agents such as 5-fluorouracil. Basal and squamous cell carcinomas are the most common nonmelanoma skin cancers. The primary cause is cumulative exposure to ultraviolet radiation from the sun, although other factors exist. Treatment is generally surgical excision performed by a practitioner skilled in this type of procedure contingent on tumor type, size, location, aggressiveness, and other factors. Other common treatments include electrodesiccation and curettage and cryotherapy. The incidence of malignant melanoma is the fastest rising cancer in the United States. Early detection and prevention are the mainstays of a good outcome. Depth of the lesion is the primary determinant in staging and prognosis, although other factors are also important. As the incidence of skin cancer increases, primary care practitioners play an integral role in the diagnosis, treatment, and prevention of skin cancer. The importance of early detection and appropriate referral by primary care providers will become even more crucial in the prognosis of afflicted patients.