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Skin Cancer of the Feet

Painted toes lounging poolside with a good book in hand soaking up the summer’s sun.  Although it warms our earth, helps to grow our food and blasts away winter’s gloom, the sun does present a danger to our health, early aging, and skin cancer.

Skin cancer is the result of unfixable changes to the blueprint of the cell (the DNA). These alterations to our blueprint lead to abnormal growth of the skin cells that can spread throughout dominating our other bodily organs. Sometimes these changes to the blueprint just happen and other times the changes can be provoked. One culprit is the sun.

Skin cancer can develop on any part of the body, and this includes the feet and ankles. While skin cancer on the lower extremities may not be as common as on more frequently sun-exposed areas, it can still occur. Understanding the risk factors, types of skin cancer that can affect the feet, early detection, and proper management is essential for foot and ankle care.

How does the sun’s rays affect our skin?  The sun produces ultraviolet radiation (UVA and UVB), which we feel as heat. This UV radiation hits our cells and rearranges our skin’s DNA. Usually, our bodies are able to notice and correct these changes, however, over time our editing abilities deteriorate and our DNA blueprints no longer pass inspection. Wearing protective clothing, seeking shade and wearing sunscreen are all methods to protect from the suns harmful mutating rays. When purchasing sunscreen you want to purchase a SPF 15 for everyday wear and a SPF 30 for extended time outside. You should purchase a broad-spectrum sunscreen, which now due to recent FDA changes covers both UVA and UVB radiations.  Both forms of UV radiation have been show to have a role in cell mutations causing skin cancers and early aging. Sunscreen should be applied at least one half hour prior to heading outdoors.

Types of Skin Cancer Affecting the Feet

  1. Melanoma: Melanoma is the most serious form of skin cancer and can occur anywhere on the body, including the feet. It often appears as a dark spot or mole with irregular borders and varying colors. Melanoma can also develop under the nails and on the soles of the feet.

  2. Basal Cell Carcinoma: Basal cell carcinoma is the most common type of skin cancer. It typically presents as a pearly bump, a pinkish patch, or a scar-like lesion. While it’s less likely to develop on the soles, it can occur on the top of the feet.

  3. Squamous Cell Carcinoma: Squamous cell carcinoma often appears as a scaly, red patch, an open sore, or a raised growth. This type of skin cancer can develop on any part of the body, including the feet.

Risk Factors

Several risk factors can increase the likelihood of developing skin cancer on the feet:

  • Prolonged Sun Exposure: Spending a lot of time in the sun without proper protection increases the risk.

  • Fair Skin: People with fair skin are more susceptible to skin cancer.

  • Family History: If you have a family history of skin cancer, your risk may be higher.

  • Weakened Immune System: Individuals with weakened immune systems are at a greater risk.

Early Detection and Self-Examination

A brown or black line on your toenail can be an early sign of melanoma, and should be medically evaluated. In persons of African descent a black line on the toenail can be normal variant called “longitudinal melanonychia”, however, if the pigmented line has suddenly appeared or changed drastically it should be evaluated by a doctor. Additionally, if you notice a brown/black pigment “leaking” from the nail into the surrounding skin a phenomenon know as the Hutchinson’s sign you should seek an appointment as soon as possible to rule out melanoma.

Early detection is crucial for successfully treating skin cancer. To monitor your feet and ankles, use the “ABCDE” rule:

  • Asymmetry: Check if one half of a mole or lesion doesn’t match the other half.

  • Border: Observe if the edges are irregular, scalloped, or poorly defined.

  • Color: Look for variations in color, including shades of brown, black, white, red, or blue.

  • Diameter: Be aware of growths larger than 6 millimeters (about the size of a pencil eraser).

  • Evolution: Note any changes in size, shape, color, or other characteristics.

If you notice any of these changes in a mole or skin growth on your feet, consult a dermatologist or healthcare professional promptly for a professional evaluation.

Treatment and Management

Treatment for skin cancer on the feet typically involves surgical excision to remove the cancerous tissue. In some cases, Mohs surgery may be used to ensure complete removal while preserving as much healthy tissue as possible. Additional treatments, such as radiation or chemotherapy, may be recommended in cases of more advanced or aggressive skin cancer.

Prevention

Preventing skin cancer on the feet involves the following measures:

  • Sun Protection: Apply sunscreen to the exposed areas of your feet and ankles when outdoors, and wear sun-protective clothing, including wide-brimmed hats and long pants.

  • Regular Self-Examination: Conduct routine self-examinations of your feet and ankles to check for changes in moles or skin growths.

  • Seek Shade: Minimize sun exposure, especially during peak hours, by seeking shade when possible.

  • Protective Footwear: When spending time in the sun, consider wearing shoes or sandals that provide coverage and protection for your feet.

  • Professional Skin Checks: Schedule regular skin checks with a dermatologist, who can perform a thorough examination of your entire body, including your feet.

Our skin is our largest organ and our greatest defense against the outside world. It helps protect us against infection, provides our sense of touch and makes vitamin D for our bodies, however, without proper protection our skin can morph into something dangerous. The skin on our feet is not immune to the risks of sun exposure and should be pampered, protected and inspected. If you are concerned about changes to your skin or toenails please see a podiatrist.

Remember that early detection and prevention are key to effectively managing and reducing the risks associated with skin cancer of the feet. By staying vigilant and taking proactive steps, you can help ensure the health and well-being of your feet and ankles.

More information about skin cancer and sun safety can be found at the links below:

http://www.aad.org/spot-skin-cancer/understanding-skin-cancer/how-do-i-check-my-skin/what-to-look-for

http://www.skincancer.org/skin-cancer-information

http://www.cdc.gov/cancer/skin/basic_info/prevention.htm

http://www.mayoclinic.com/health/skin-cancer/DS00190

http://www.cancer.org/Cancer/CancerCauses/SunandUVExposure/skin-cancer-facts

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