The important ulcers under this category are squamous cell carcinoma, rodent ulcer of basal cell carcinoma and malignant melanoma.
Squamous cell carcinoma
It is also called epithelioma or epidermoid cancer. When an ulcer forms due to this type of skin cancer, it is called the ulcerative type which is more common compared to the proliferative type.
It begins as a small raised bump which then becomes an ulcer. The ulcer has raised edges and the floor is covered with blood and debris. Sometimes the underlying muscle or bone is visible.
Treatment: Surgical excision of the ulcer and the surrounding part is done.
Rodent skin ulcer
This type of cancer is common in fair skinned people with dry skin and who are regularly exposed to the sun. It is common during old age. It more often than not appears on the face and men are more often affected than women as they probably spend more time outdoors. The ulcer is generally seen at the site where tears normally roll down, hence the name `tear cancer’ is given to it.
The ulcer has a rolled out edge and deeply erodes the deeper tissues (muscle, fat or bone), hence the name rodent ulcer.
Treatment: Radiotherapy is the first line of treatment.
Malignant melanoma
This cancer commonly affects any part of the skin or the pigmented layers of the eye. Palms, soles, genitalia and the area below the nail are the frequently affected sites. It is more common in women than men and seen during their middle age. It may also arise from an already existing naevus (a benign skin lesion).
The ulcer tends to bleed and increases in size rapidly. It is a painless ulcer but itching maybe a feature.
Treatment: Surgery is the best method to get rid of the ulcer.
Prevention of skin ulcers
- Avoiding repeated trauma to a body part is important to prevent traumatic ulcers.
- Staying away from chemical reagents and acid or wearing protective gear is important while handling these substances.
- Diabetics need to follow a strict diet and keep their blood sugar within normal limits and also inspect their feet regularly and avoid ill fitting shoes and shoe bites which may lead to ulcer formation.
- In cases of specific infections like tuberculosis and syphilis, prompt treatment with the recommended antibiotics is of utmost importance.
- People working for long hours in the outdoors may be prone to bacterial or fungal ulcers and should consult a doctor promptly and take proper treatment.
- To prevent skin cancer wear protective clothing when outdoors and use sunscreen generously.
- If a tooth has a jagged edge, a visit to the dentist is in order as the edge can be smoothened to avoid irritation and ulceration of the tongue.
Photograph via sxc.hu
Written by Dr Nisreen Nakhoda, General Physician
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