Michelle Rupp: Hello and welcome into this week’s edition of AFMC TV. We’re glad you’re here joining us today is Rebecca Denniston from the Dermatology Group of Arkansas. So glad you’re joining us today.

Rebecca Denniston, PA-C: Yes, thank you for having me.

MR: So, may is skin cancer awareness month.

RD: That’s right.

MR: So, what types of skin cancer are out there?

RD: Yes. So great time of year to talk about skin cancers right before summer, right before you’re out a bunch. There’s three main types of skin cancer. The most aggressive form is melanoma. So, melanoma is going to be the most deadly form and the one that we worry about the most typically, but then there’s also basal cell and squamous cell skin cancers.   so those are kind of the three main ones that we look out for in your skin exams.   they can come on at any point in your life. So, majority of people are going to see those types of skin cancers later in life, but we also diagnose them in younger patients as well.

MR: Is there any place on the body that they particularly like to pop up or is any surface free game?

RD: Yes. So, think about sun exposed areas. So, for men a lot of times you’re going to see them more on the back, especially with melanoma   on females. A lot of times it’s the legs. The face is a very common place, the nose and the ears especially. Yes, especially for men because a lot of times men wear ball caps and their ears are exposed.   and then also kind of the back of the neck. So, places where you know that sun is kind of beaming down on your body.

MR: What about your scalp?

RD: Yes, good question, definitely. It can be found on the scalp. So, you can get skin cancer, especially melanoma in places that don’t see the sun, but most commonly we’re gonna see it on the scalp in your part line. So, uh you know, a lot of people wear visors, you don’t really have that coverage on the top of the head or maybe you don’t wear a hat at all. And so your parts exposed and your part may burn.   and that puts you at greater risk for skin cancer later in life.

MR: I know you kind of answered this question earlier but are all skin cancers cancerous.

RD: Yes, definitely. Now there’s varying types of each skin cancer. So, for instance, a basal cell skin cancer, we kind of say it’s the best kind of skin cancer you can get because it’s a skimmer, it tends to stay on the surface. Typically, it doesn’t dive down like say a melanoma would. And then same for squamous cell skin cancers.   Those can be varying types as well. They can be superficial or invasive. So, each skin cancer has a different kind of subset or type.

MR: What are we talking about when it comes to treatment, is it you know, pretty, intense kind of treatment or I guess obviously it depends on what kind of cancer it is.

RD: It does. So, melanoma, it’s typically a further excision. So, a margin is going to be taken around that biopsy site and then all that tissue is tested again.  And so, we call those excisions and then   for basal cell and squamous cell.   The most common treatment is a procedure called a Mohs procedure. And Mohs procedures are a micro graphic procedure where the skin cancers cut out and then it’s immediately looked at under the microscope that tissue to make sure that the whole thing is taken out before they sew you back up.   so those are kind of the common ways.

MR: And do those happen in the office or are we going into the hospital for these?

RD: So, nine times out of 10 they’re going to be in the office. Nothing that you have to be put to sleep for now. There’s a rare case if you have an aggressive form of skin cancer or maybe a really large skin cancer that you might have to be, you know, put to sleep for those. But most of the time it’s in clinic.

MR: So, let me ask you   And I might be dating myself here but I grew up in the era of tanning beds and a lot of folks did. And you know, you always kind of wanted to lay in the tanning bed before you went to Florida.   so you kind of had your base tan already on. So   how is there a window of time that those who, those of us who used to lay in tanning beds that we need to either begin to be very diligent in dermatology visits or very observant on anything that may be popping up on our skin. Is there is there a window of time?

RD: Yes, definitely. I think yes, to both of your questions. So, the big thing now, more and more studies are being done on tanning beds and risk of skin cancer in particular melanoma. So, to date the kind of statistics show that the tanning bed usage increases your risk of melanoma by 70% which is a huge number. So, we’re seeing more and more younger patients with skin cancer probably from tanning bed use. So, I think a baseline skin check when you’re younger, you know, if you have a ton of goals, we may see you in your teens or even earlier, but for the average person, a baseline skin check in your twenties or thirties is a good idea. And then depending upon, you know, if we find anything worrisome or if you have a ton of molds, we may see you for skin checks every year every few years   just kind of dependent upon the person.

MR: Just keeping an eye on it.

RD: Exactly.

MR: Ok. SPF, because that’s the best line of defense, right? In addition to hats and clothing and that kind of thing. The higher the number, the better the coverage.

RD: To an extent. So, what’s recommended is anything SPF 30 or greater and then kind of once you get around the 50 mark, if you go above 50 there’s not much difference between 50 and 100 or 75 and 100. They’re pretty equivalent. So, the recommendation is anything 30 or greater and then re application is the big thing. So yes, so you really want to apply every you know, two hours if you’re out in the sun but if you’re, you know sweating or you’re jumping in the pool, you really want to do it every hour.

MR: Alright. Anything else we need to know?

RD: I think that the big thing is, you know, paying attention to your body is super important, so if you see moles that are changing, you know, maybe they’re kind of looking different, they’re not symmetrical, they have a different color to the edges are funky looking or you have a spot that’s bleeding or not healing. Those are reasons to come in and have a skin check.

MR: Okay Becca thank you so much.

RD: Yes, you’re welcome.