Diagnosis

Common Symptoms of NMSC

Most non-melanoma skin cancers can be treated effectively if diagnosis is made at an early stage. A change in appearance of the skin is the most common symptom of a NMSC, however there are occasionally other symptoms to look out for:

  • Development of small smooth lump that is red/pink/pearly dome-shaped.
  • Small scaly or crusted areas of skin with a red, pink or brown base.
  • Bleeding sore or lump.
  • Red spots that are itchy, tender and flat.
  • Other changes to a spot or a lesion that may indicate that testing may be required:
    • Change in size.
    • Spot with an irregular shape.
    • Irregular colour.
    • Inflamed spot/lesion.
    • Ulcerated spot/lesion.
    • Oozing.

Diagnosis of NMSC

Before definitive diagnosis can take place, the medical history of the patient is checked with particular attention paid to the following: sun exposure, radiation (UV/X-rays), skin-type, age, factors causing immunosuppression, exposure to harmful substances such as arsenic/carcinogens, timing of the changes in the skin, and any familial incidences of skin cancer.

Biopsy is the gold standard of NMSC diagnosis. There are four types of biopsies:

  1. Punch biopsy - this method involves using a sharp and hollow tool to remove a small oval shaped sample from the centre of the lesion/spot.
  2. Incisional biopsy - removal of a portion of the abnormal skin area for histological examination.
  3. Excisional biopsy - removal of the whole potentially affected lump for histological examination.
  4. Shave biopsy - shavings of the lump are taken by a sharp scalpel for microscopic examination.

The most common differential diagnoses of NMSC are benign tumours or other types of skin cancers . More rarely, they may be confused with inflammatory or infectious lesions such as skin tuberculosis, leishmaniasis, pyogenic granuloma, discoid lupus, lichen planus and tinea corporis.