Last reviewed: 22 Aug 2021
Last updated: 23 Apr 2021

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • growing tumours

Other diagnostic factors

  • previous skin cancer
  • bleeding
  • crusting
  • evidence of sun damage to skin
  • tender or itchy non-healing wound originally caused by trauma
  • erythematous papules or plaques
  • thin, flesh-coloured or erythematous plaques
  • dome-shaped nodule
  • exophytic, fungating, verrucous nodules or plaques
  • ulcerated tumours
  • lymphadenopathy
  • bone pain
  • hepatomegaly
  • neurological signs

Risk factors

  • Ultraviolet radiation exposure
  • immunosuppression
  • fair skin
  • human papillomavirus
  • hereditary skin conditions
  • older age
  • male sex
  • ionising radiation
  • carcinogens
  • actinic keratosis
  • previous skin cancer
  • tobacco smoking
  • thiazide diuretics and cardiac drugs
  • tattoos

Diagnostic investigations

Investigations to consider

  • CT body scan
  • MRI scan
  • PET scan
  • FBC with differential
  • LFTs
  • chest x-ray

Emerging tests

  • non-invasive imaging technologies

Treatment algorithm

Contributors

Authors

Keyoumars Soltani, MD
Keyoumars Soltani

Professor

Department of Medicine

Director of Immunopathology

Laboratory Section of Dermatology

The University of Chicago

Chicago

IL

Disclosures

KS declares that he has no competing interests.

Adaobi Nwaneshiudu Obasi, MD, PhD, FAAD
Adaobi Nwaneshiudu Obasi

Medical Director, Dermatologist, and Dermatopathologist

Cutis Wellness Dermatology & Dermatopathology, PLLC

Preceptor

University of the Incarnate Word

Department of Family Medicine

Laredo

TX

Disclosures

AIN declares that she has no competing interests.

Acknowledgements

Prof K. Soltani and Dr A. I. Nwaneshiudu would like to gratefully acknowledge Dr Carlos Paz and Dr Jessica M. Sheehan, the previous co-contributors to this topic. CP and JMS declare that they have no competing interests.

Peer reviewers

Nanette Silverberg, MD

Clinical Professor of Dermatology

Columbia University College of Physicians and Surgeons

New York City

NY

Disclosures

NS declares that she has no competing interests.

Iris Aronson, MD

Associate Head

Associate Professor

Department of Dermatology

University of Illinois

Chicago

IL

Disclosures

IA declares that she has no competing interests.

Keyvan Nouri, MD

Professor of Dermatology & Otolaryngology

Director of Mohs, Dermatologic & Laser Surgery

Director of Surgical Training

Department of Dermatology & Cutaneous Surgery

University of Miami

Miami

FL

Disclosures

KN declares that he has no competing interests.

Jane McGregor, MA, MB, BChir, MRCP, MD

Senior Lecturer and Honorary Consultant Dermatologist (Barts and the London NHS Trust)

Institute of Cellular and Molecular Science

London

UK

Disclosures

JMG declares that she has no competing interests.

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