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Precursor Lesions of Skin Cancer

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Dermatology in Public Health Environments

Abstract

Skin cancer is more common than any other type of cancer. In view of the impact of skin cancer on public health, this chapter is dedicated to recognizing and treating precursor lesions of melanoma and nonmelanoma skin cancer. We divide the precursor lesions into three main groups. In the cutaneous melanoma precursor lesions group we discuss congenital melanocytic nevus, dysplastic nevus, and acquired melanocytic nevus. In the basocellular carcinoma precursor lesions group we discuss nevus sebaceus, and in the spinocellular carcinoma precursor lesions group we discuss actinic keratosis, porokeratosis, cutaneous horn, chronic scars, oral leukoplakia and erythroplakia, oral lichen planus, lichen sclerosus, and precursor lesions of skin cancer related to human papillomavirus.

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Authors and Affiliations

  1. Private Practice, Av Getulio Vargas 901/1003, Menino Deus, Porto Alegre, Rio Grande do Sul, CEP 90150-003, Brazil

    Majoriê Mergen Segatto

  2. Private Practice, Av Presidente Vargas 2355/613, Centro, Santa Maria, Rio Grande do Sul, CEP 97015-513, Porto Alegre, Brazil

    Eloísa Unfer Schmitt Botton

Authors
  1. Majoriê Mergen Segatto
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  2. Eloísa Unfer Schmitt Botton
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Correspondence to Majoriê Mergen Segatto .

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Editors and Affiliations

  1. Dermatology Service of Clinical, Hospital of Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil

    Renan Rangel Bonamigo

  2. Health Secretary of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

    Sergio Ivan Torres Dornelles

Glossary

Actinic keratoses

Epidermal lesions at the initial clinical stage of a biological continuum that may culminate in spinocellular carcinoma. They generally result from prolonged exposure to nonionizing radiation, especially ultraviolet. It has been characterized as a premalignant or precursor lesion of skin cancer, because it presents atypical keratinocytes confined in the epidermis.

Congenital melanocytic nevus

Melanocytic nevus that is present at birth or rarely up to 2 years of age. It is believed to result from the rapid proliferation of melanocytic lineage cells due to some morphologic error of the neuroectoderm, during the migration of the melanoblasts from the neural crest to the skin.

Cutaneous horn

A clinical term for a firm, white to yellow, conical, keratotic papule or plaque ranging from a few millimeters to several centimeters in size. Spinocellular carcinoma is the most common neoplasia associated with malignant-based horn.

Dysplastic nevus

Described as a continuum between the common acquired nevus and the melanoma, since it is morphologically and biologically the intermediate between these two entities.

Erythroplakia

A fiery red patch that cannot be characterized clinically or pathologically as any other definable disease. It is classified as an oral potentially malignant disorder.

Giant congenital melanocytic nevus

Congenital melanocytic nevus of ≥20 cm that generally presents as a brownish lesion with defined margins and hypertrichosis. The association with melanoma is well established.

Human papillomaviruses

Consist of a heterogeneous group of nonenveloped, double-stranded DNA viruses that display a distinct tropism for mucosal or cutaneous squamous epithelia. They are associated with development of malignancies, particularly high-risk HPV types.

Lichen sclerosus

An autoimmune, inflammatory dermatosis, characterized by a lymphocytic response that has a predilection for the genital skin in both sexes, and an association with several other autoimmune diseases.

Marjolin’s ulcer

This term refers to carcinomas arising both from chronically inflamed and scarred skin.

Nevus sebaceus

A hamartoma of epithelial and nonepithelial origin that is often referred to as an organoid nevus because it may contain any or all components of the skin.

Oral leukoplakia

A white plaque of questionable risk having excluded (other) known diseases or disorders that carry no risk. It is classified as an oral potentially malignant disorder.

Porokeratosis

A group of cutaneous entities characterized by disordering of epidermal keratinization, presence of a cornoid lamella, and a predisposition to develop malignant transformation.

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Segatto, M.M., Botton, E.U.S. (2018). Precursor Lesions of Skin Cancer. In: Bonamigo, R., Dornelles, S. (eds) Dermatology in Public Health Environments. Springer, Cham. https://doi.org/10.1007/978-3-319-33919-1_13

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