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Dermatologist often use the term precancer when describing skin lesion to patients. “It can actually create a lot of anxiety,” says Dr. Adam Mamelak, board certified dermatologist and fellowship-trained Mohs surgeon in Austin, Texas. “While patients are relieved to know that they do not have skin cancer, they’re also somewhat uncomfortable in being in the gray zone and a little uncertain what to do next.”
“A dermatologist might use the term precancer in a few different clinical scenarios,” explains Dr. Mamelak. For example, skin cancers often arise out of rough and scaly patches on the skin, known as actinic keratosis. These are typically seen on skin that has been chronically exposed and damaged by the sun.” Although there is no guarantee that an actinic keratosis will transform into a squamous cell carcinoma or basal cell carcinoma skin cancer, and the rates at which these precancerous lesions change can vary, most dermatologist will still recommend treatment. “These are the spots we spray with liquid nitrogen, or treat with creams like imiquimod, efudex or picato, to really decrease and eliminate this risk.”
Pigmented lesions and moles are other areas where a dermatologist might use the term precancer. When a skin biopsy is performed and these suspicious moles are examined under the microscope, physicians will often describe them as atypical or dysplastic. “While technically not a skin cancer, there are changes within the cells and nuclei of the mole that are not considered benign,” claims Dr. Mamelak
“Whether or not an atypical mole will develop into a melanoma, or how long a process that might take, is unfortunately not something that we know,” says Dr. Mamelak. In theory, the presence of an atypical mole places an individual at higher risk of developing skin cancer. As well, if atypical moles run in the family, skin cancer might occur at higher rates in those affected families. “Depending on the degree of atypia, a dermatologist might advise just watching these atypical moles, or potentially surgically removing them.”
Dr. Mamelak specializes in treating patients with actinic keratosis, atypical moles and skin cancer at Sanova Dermatology and the Austin Mohs Surgery Center.
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