Laserklinik DRes Steinert

The malignant melanoma / black skin cancer is the most malignant skin tumour, since it can metastaszie at an early stage. Through skin cancer early recognition measures, it is in the most cases diagnosed early enough, in its beginning stage. Therefore, the survival rate has significantly improved. German Cancer Society and German Dermatologic Society offer further information about the malignant melanoma.

Due to Josephine Baker, suntanned skin is considered chic. Unfortunately, the brown colour caused by the ultra-violet solar irradiation is not good for your health; it is a protection mechanism of our skin. Under UV irradiation, pigment cells begin to develop protecting pigment after a period time and the skin turns brown.

Under a short but intensive irradiation, the skin turns red after a short period of time, which differs from person to person, and sunburn appears.

This results in damaging of genetic substance of the cells in the upper skin layers. This damage is partly compensated by body-own repair mechanisms, but not always perfectly well. During repeated sunburns, damage in the genotype of the cells by and by remains, multiplies and can lead to degeneration.

Definition of a light type can become an approximate guideline to application of sun cremes, and the behaviour in the sun at work and at leasure. Yet even the best sun creme does not protect from the skin cancer for sure, since cancer can also appear on the areas that have not been under the sun. Anyway, it makes sense to spend as little time under the sun as possible, and if you still do it, then to use as much protection as possible. The skin “records” every solar irradiation and it is irrevocable. For this reason visit your dermatologist every year and undergo a skin examination. Almost everyone has birthmarks or pigmented lesions. It is important that they are observed on a regular basis. If there are any changes in shape, colour, size and behaviour (itching, encrustation, bleeding), turn to your dermatologist. He will remove the suspicious changes and send them for a laboratory examination. Often after a thorough examination with the help of reflected light microscopy all concerns can be forgotten.

A: Assymetrie (whether the spot is round, oval etc)

B: Border ( whether the spot has a distinctive border with the surrounding skin, or the border is indistinctive)

C: Colour of the spot (whether it is black, brown, red, grey, or a mixture of these colours)

D: Diameter. To begin with, find out whether the spot is bigger or smaller or has a 5 mm size.

E: Evolution. A birthmark which constantly grows, is suspicious

In the case of suspected skin cancer, the suspicious spot is cut out under local anaesthesia. If the suspicion were strong enough, an additional safety margin would make sense. The removed material is sent to the laboratory, and examined under a microscope. If suspected tumour is confirmed, an additional cut, the size of which will depend on the penetration depth of the melanoma is required.

In the case of skin-deep basal cells carcinomas or solar precancerous state, freezing with liquid azote is applied, to destroy the affected areas of skin. This method is especially used in the case of contra indications to surgical removal (for example in patients with blood coagulation disorders).

Photodynamic diagnostics (PDD) followed by photodynamic therapy (PDT) is a invaluable treatment option.

To treat melanoma, chemotherapy is used either indiovidually or in combination with various chemotherapeutika or with immunotherapy if metastasis are present.

Early recognition of skin cancer by means of digital analysis of samples

In the recent 10 years, the number of malignant melanomas (so called “black skin cancer”) has doubled almost everywhere in the world. In Germany, the number of newly diagnosed cases each year is from 10 to 12 per 100000 inhabitants, the absolute amount of the newly diagnosed cases is from 9000 to 10000, and the current annual growth rate is from 5 to 10%.

The healing chances of the black cancer depend on the tumour thickness that is why if diagnosed early enough the chances for healing are very high. Through a better medical enlightenment of the population, melanomas are diagnosed much earlier nowadays and are treated with a high survival rate. It is assumed that because of an ozone hole, the risk to develop melanoma or non-melanoma cancer continuously grows. This stresses the importance of skin cancer early recognition (“skin check”), during which the whole skin surface including the head skin and visible mucous membrane on the suspicious changes must be examined for suspicious changes.

As examination tools dermatologists use a clinical look and a special magnifying glass. Pigmented changes are always assessed under a reflection light microscope. Due to a 10x magnification, the skin changes can be examined more thoroughly. The diagnostic security of the examination has risen to 95% per cent.

An even higher examination quality and the diagnostic security is possible with the help of digital analysis of samples. We have offered it since 1996. Recording with a special video-camera makes it possible to get a significantly better resolution of the clinical picture of the skin change. Due to a high resolution, this procedure is superior to a human eye. In addition to that, through the connection of algorithms a computer-supported assesement of birthmarks can be carried out (Tubinger mole analyser). All this results in precise assessment of doubtful findings.

An additional important aspect is digital image storage, which gives a chance to compare the image months and years later. (Point E of the ABCDE rule).

It is especially important to observe whether a birthmark remains unchanged or there are signs of activity. Due to this method, suspicious birthmarks can be left there for observation and do not have to be surgically removed for security reasons. This advantage is especially important during pregnancy and in childhood. It is now possible to compare the smallest changes in the cource of years, as well as overview images of body parts. Old and new images can be put near each other, side by side, and compared.

As part of skin cancer early recognition examination (skin check) video documentation is offered to you as an additional service.