2001 Santa Monica Blvd, Suite 990W, Santa Monica, CA, 90404 - ph (310) 829-4484, fax (310) 829-4481

All providers at Santa Monica Dermatology Medical Group are experienced in the treatment of acne, psoriasis, eczema, rashes, hair loss, nail disease and all forms of skin cancer. We offer numerous cosmetic services to keep you looking your best and our goal is keep your skin healthy. 

Skin Cancers

Skin cancer is the most common form of human cancers, affecting more than one million Americans every year. One in five Americans will develop skin cancer at some point in their lives. In fact, skin cancer is more common than all other types of cancer combined. Skin cancers are generally curable if caught early. However, people who have had skin cancer are at a higher risk of developing a new skin cancer, which is why regular self-examination and doctor visits are imperative.

The vast majority of skin cancers are composed of three different types: Basal cell carcinoma, Squamous cell carcinoma and Melanoma.

Basal Cell Carcinoma

This is the most common form of skin cancer. Basal cells reside in the deepest layer of the epidermis, along with hair follicles and sweat ducts. When a person is overexposed to UVB radiation, it damages the body's natural repair system, which causes basal cell carcinomas to grow. These tend to be slow-growing tumors and rarely metastasize (spread). Basal cell carcinomas can present in a number of different ways:

  • raised pink or pearly white bump with a pearly edge and small, visible blood vessels
  • pigmented bumps that look like moles with a pearly edge
  • a sore that continuously heals and re-opens
  • flat scaly scar with a waxy appearance and blurred edges

Despite the different appearances of the cancer, they all tend to bleed with little or no cause. Eighty-five percent of basal cell carcinomas occur on the face and neck since these are areas that are most exposed to the sun.

Risk factors for basal cell carcinoma include having fair skin, sun exposure, age (most skin cancers occur after age 50), exposure to ultraviolet radiation (as in tanning beds) and therapeutic radiation given to treat an unrelated health issue.

Diagnosing Basal cell carcinoma requires a biopsy using a small blade to obtain a sample of the lesion for pathologic testing. (deleted blurb about incisional vs excisional biopsies)

The optimal treatment for any given basal cell carcinoma is determined by the tumor’s location, size, and subtype. Some basal cell carcinomas are considered low-risk and others are considered high-risk for recurrence. Treatment options include:

  • Curettage and Desiccation — This treatment involves using a small metal instrument called a curette to scrape out the tumor, along with the application of electric cautery to kill off any remaining cancer cells. It is used for low-risk, non-aggressive types of skin cancer. The cure rate is not as high as surgery or radiation.

  • Surgical Excision — With this treatment the tumor is surgically excised with appropriate margins depending on the aggressiveness of the tumor. The specimen is sent to pathology to ensure the tumor has been completely removed.

  • Mohs Micrographic Surgery — This is the preferred method for treating high-risk skin cancer and skin cancer in cosmetically sensitive areas. Mohs Micrographic Surgery is a very precise, microscopically-conrolled outpatient procedure. The technique combines the surgical removal of cancerous tissue with the microscopic examination of 100% of the surgical margin. Mapping is done of any cancerous ‘roots’ seen under the microscope (hence the term ‘micrographic’). Using this technique, the roots of skin cancer are mapped out and excised sequentially, layer by layer, on the same day. This procedure is time-consuming while tissue is examined and mapped, and often requires several hours of waiting in the office. Mohs surgery offers the highest cure rate and spares as much normal tissue as possible, resulting in the smallest scar. Dr Jason Ryan Litak completed a general surgery internship, a dermatology residency, and an advanced fellowship in Mohs surgery, pathology, and reconstructive surgery (only 70 such fellowships exist.) After fellowship, he practiced at Kaiser Permanente as a full-time Mohs surgeon performing 800 cases per year. 

    Dr. Litak has a passion for the surgical management of skin cancer and reconstruction after skin cancer removal. He is available for the evaluation and management of known or suspected skin cancer and accepts referrals for Mohs from doctors in the community. 

 

Squamous Cell Carcinoma

Squamous cells are found in the upper layer (the surface) of the epidermis. They look like fish scales under a microscope and present as a crusted or scaly patch of skin with an inflamed, red base. They are often tender to the touch. It is estimated that 250,000 new cases of squamous cell carcinoma are diagnosed annually, and that 2,500 of them result in death.

Squamous cell carcinoma can develop anywhere, including inside the mouth and on the genitalia. It most frequently appears on the scalp, face, ears and back of hands. Squamous cell carcinoma tends to develop among fair-skinned, middle-aged and elderly people who have a history of sun exposure. In some cases, it evolves from actinic keratoses, dry scaly lesions that can be flesh-colored, reddish-brown or yellow black, and which appear on skin that is rough or leathery. Actinic keratoses spots are considered to be precancerous.

Like Basal cell carcinoma, Squamous cell carcinoma is diagnosed via a biopsy.

The optimal treatment for any given squamous cell carcinoma is determined by the tumor’s location, size, and subtype. Some squamous cell carcinomas are considered low-risk and others are considered high-risk for recurrence. A minority of squamous cell carcinomas will metastasize (spread), and fewer still will cause death. Treatment options include:

  • Curettage and Desiccation — This treatment involves using a small metal instrument called a curette to scrape out the tumor, along with the application of electric cautery to kill off any remaining cancer cells. It is used for low-risk, non-aggressive types of skin cancer. The cure rate is not as high as surgery or radiation.

  • Surgical Excision — With this treatment the tumor is surgically excised with appropriate margins depending on the aggressiveness of the tumor. The specimen is sent to pathology to ensure the tumor has been completely removed.

  • Mohs Micrographic Surgery — This is the preferred method for treating high-risk skin cancer and skin cancer in cosmetically sensitive areas. Mohs Micrographic Surgery is a very precise, microscopically-conrolled outpatient procedure. The technique combines the surgical removal of cancerous tissue with the microscopic examination of 100% of the surgical margin. Mapping is done of any cancerous ‘roots’ seen under the microscope (hence the term ‘micrographic’). Using this technique, the roots of skin cancer are mapped out and excised sequentially, layer by layer, on the same day. This procedure is time-consuming while tissue is examined and mapped, and often requires several hours of waiting in the office. Mohs surgery offers the highest cure rate and spares as much normal tissue as possible, resulting in the smallest scar. Dr Jason Ryan Litak completed a general surgery internship, a dermatology residency, and an advanced fellowship in Mohs surgery, pathology, and reconstructive surgery (only 70 such fellowships exist.) After fellowship, he practiced at Kaiser Permanente as a full-time Mohs surgeon performing 800 cases per year. 

    Dr. Litak has a passion for the surgical management of skin cancer and reconstruction after skin cancer removal. He is available for the evaluation and management of known or suspected skin cancer and accepts referrals for Mohs from doctors in the community. 

  • Radiation Therapy — Radiation therapy is usually used to treat skin cancer when surgery is either contraindicated or undesirable. Radiation therapy typically requires 15-20 treatment sessions and may result in a healing wound and a scar.

  • Prescription Medicated Creams and Cryotherapy — The cure rate when treating skin cancer with these methods is lower than with surgery or radiation, therefore they are typically reserved for low-risk, superficial lesions, and when surgery or radiation is contraindicated. These treatments are routinely used to treat pre-cancerous lesions (actinic keratoses).

Melanoma

While Melanoma is the least common type of skin cancer, it is by far the most dangerous. It is the most common form of cancer among young adults age 25 to 29. Melanocytes are cells found in the bottom layer of the epidermis. These cells produce melanin, the substance responsible for skin pigmentation. That's why Melanomas often present as dark brown or black spots on the skin. Melanomas spread rapidly to internal organs and the lymph system, making them quite dangerous. Early detection is critical for curing this skin cancer.

Melanomas look like moles and often do grow inside existing moles. That's why it is important for people to conduct regular self-examinations of their skin in order to detect any potential skin cancer early, when it is treatable. Most melanomas are caused by overexposure to the sun beginning in childhood. This cancer also runs in families.

Melanoma is diagnosed via a biopsy. Treatments include surgical removal, radiation therapy and/or chemotherapy.

What to Look For

The key to detecting skin cancers is to notice changes in your skin. Look for:

  • Large brown spots with darker speckles located anywhere on the body.
  • Dark lesions on the palms of the hands and soles of the feet, fingertips, toes, mouth, nose or genitalia.
  • Translucent pearly and dome-shaped growths.
  • Existing moles that begin to grow, itch or bleed.
  • Brown or black streaks under the nails.
  • A sore that repeatedly heals and re-opens.
  • Clusters of slow-growing scaly lesions that are pink or red.

The American Academy of Dermatology has developed the following ABCDE guide for assessing whether or not a mole or other lesion may be becoming cancerous.

Asymmetry: Half the mole does not match the other half in size, shape or color.

Border: The edges of the mole are irregular or blurred.

Color: The mole is not the same color throughout.

Diameter: The mole is larger than one-quarter inch in size.

Evolution: The mole changes in any way.

If any of these conditions occur, please make an appointment to see one of our dermatologists right away. The doctor may do a biopsy of the mole to determine if it is or is not cancerous.

Prevention

Roughly 90% of nonmelanoma cancers are attributable to ultraviolet radiation from the sun. That's why prevention involves:

  • Staying out of the sun during peak hours (between 10 a.m. and 4 p.m.).
  • Covering up the arms and legs with protective clothing.
  • Wearing a wide-brimmed hat and sunglasses.
  • Using sunscreens year round with a SPF of 30 or greater and sunblocks that work on both UVA and UVB rays. Look for products that use the term "broad spectrum."
  • Checking your skin monthly and contacting your dermatologist if you notice any changes.
  • Getting regular skin examinations. It is advised that adults over 40 get an annual exam with a dermatologist.

Acne

Acne is the most frequent skin condition seen by medical professionals. It consists of pimples that appear on the face, back and chest. About 80% of adolescents have some form of acne and about 5% of adults experience acne. In normal skin, oil glands under the skin, known as sebaceous glands, produce an oily substance called sebum. Read More »

 

Moles (Nevi)

Moles are brown or black growths, usually round or oval, that can appear anywhere on the skin. They can be rough or smooth, flat or raised, single or in multiples. They occur when cells that are responsible for skin pigmentation, known as melanocytes, grow in clusters instead of being spread out across the skin. Generally, moles are less than one-quarter inch in size. Most moles appear by the age of 20, although some moles may appear later in life. Read More »

 

Psoriasis

Psoriasis is a skin condition that creates red patches of skin with white, flaky scales. It most commonly occurs on the elbows, knees and trunk, but can appear anywhere on the body. The first episode usually strikes between the ages of 15 and 35. It is a chronic condition that will then cycle through flare-ups and remissions throughout the rest of the patient's life. Psoriasis affects as many as 7.5 million people in the United States. About 20,000 children under age 10 have been diagnosed with psoriasis. A good resource for more information regardiing Psoriasis can be found at http://www.psoriasis.org/    Read More »

 

Rashes

"Rash" is a general term for a wide variety of skin conditions. A rash refers to a change that affects the skin and usually appears as a red patch or small bumps or blisters on the skin. The majority of rashes are harmless and can be treated effectively with over-the-counter anti-itch creams, antihistamines and moisturizing lotions. Read More »

 

Rosacea

Rosacea is a chronic skin condition that causes facial redness, acne-like pimples, visible small blood vessels on the face, swelling and/or watery, irritated eyes. This inflammation of the face can affect the cheeks, nose, chin, forehead or eyelids. More than 14 million Americans suffer from rosacea. It is not contagious, but there is some evidence to suggest that it is inherited. There is no known cause or cure for rosacea. There is also no link between rosacea and cancer. A good resource for information regarding Rosacea can be found at  http://www.rosacea.org/index.php  Read More »

 

Warts

Warts are small, harmless growths that appear most frequently on the hands and feet. Sometimes they look flat and smooth, other times they have a dome-shaped or cauliflower-like appearance. Warts can be surrounded by skin that is either lighter or darker. Warts are caused by different forms of Human Papilloma Virus (HPV). They occur in people of all ages and can spread from person-to-person and from one part of the body to another. Warts are benign (noncancerous) and generally painless. Read More »