November 12, 2019

Skin Cancer, the Ugly Duckling

By Riverside Medical Arts


A few years ago, I came across an old Disney cartoon entitled The Ugly Duckling. I recognized it as one I had seen as a child. As the story goes, a mother duck has many beautiful ducklings, but one does not look like the others. The odd looking duck is ostracized by his siblings. He is sad and lonely until he comes across some baby swans. Catching a glimpse of himself in the water, he recognizes that he is not a duck but is a swan. He joins the swan family and lives happily ever after. 

The ugly duckling phenomenon can be a helpful tool in the detection of skin cancer. The concept is based on the Sesame Street principle that “one of these is not like the others.” When it comes to skin cancer, our spots frequently don’t look or act like other “normal” spots. Skin cancers generally are changing, growing over a few weeks or months, tender to touch, rough, itchy, darker in color, or just new and different. The goal is to find these spots early in their development in order to live skin-cancer free and happily ever after. 

There are three principal types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. 

Basal cell carcinoma occurs most commonly on sun-exposed skin but can occur anywhere on the body. It frequently presents as a small, skin-colored or pink bump which grows very slowly. It can bleed with minimal trauma, such as washing or drying the face. Basal cell carcinoma is very slow growing and is treated with surgery. It rarely spreads to lymph nodes or other parts of the body. If left untreated, it can burrow into deeper tissues, becoming much more complicated to treat with surgery or radiation. 

Squamous cell carcinoma is the second most common cancer of the skin. It occurs principally on the head and neck but can affect all parts of the body. It is generally easily treated with surgery, but unlike basal cell carcinoma, squamous cell carcinoma can spread to lymph nodes and other organs. High risk areas include the lips and ears. It usually appears as a red, scaly, tender-to-touch bump on the skin that can double in size over the course of just a few weeks. 

Melanoma is the most deadly form of skin cancer and can occur anywhere on the body. Melanoma frequently presents as a new or changing brown or black spot on the skin. It can spread into lymph nodes and almost any other organ of the body. Melanoma can be fast or slow growing. It can arise in an old mole or present as a new mole. 

The ABCDEs of moles are used to help patients determine if a mole needs to be seen by a dermatologist. 

  • Asymmetry: Melanoma lesions are often irregular or asymmetrical in shape.
  • Border: Melanoma lesions usually have irregular borders that are difficult to define. 
  • Color: The presence of more than one color (blue, black, brown, tan, etc.) or the uneven distribution of color can sometimes be a warning sign of melanoma. Benign moles are usually a single shade of brown or tan. 
  • Diameter: Melanoma lesions are often larger than a pencil eraser. 
  • Evolution: Changing moles should be evaluated by a dermatologist. Generally, moles do not change visibly over short periods of time. 

If you or a family member are concerned about an “ugly duckling” on your skin, don’t put off having it checked by a physician. Please call Riverside Medical Arts at (435) 628-6466 to schedule an appointment.


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