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Recent Updates on Evaluation and Treatment of Skin Cancer (Skin Cancer)
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Recent Updates on Evaluation and Treatment of Skin Cancer

Richard Thomas, MD, FRCPC

Two major updates have made recent news in the medical community concerning skin cancer.

The first is an update on the well known ABCD guide for identifying and diagnosing melanoma. The second is the approval of Imiquimod (Aldara™, by 3M) cream, used to treat superficial basal cell cancer.

Addition to the Evaluation Guide:

Identification of potential melanoma is often understood as ABCD when examining moles:

  • A: Asymmetrical—Uneven shape
  • B: Border—Irregular borders
  • C: Color—The color is dark brown or black
  • D: Diameter—It should have a diameter of 0.6 cm

An additional acronym for identification has been added.

  • E: Evolving—Mole is evolving or changing

You are looking for dark brown or black moles that are different in pattern from other moles, ones that are changing at a fast pace. Also, one characteristic of melanoma is that they are rapidly changing, so if you suspect a mole is suspicious don’t wait until the mole is larger in diameter than 0.6 cm. The earlier that skin cancer is discovered, the more effectively it can be treated.

Imiquimod approved for treatment of basal cell skin cancer:


Imiquimod (Aldara™) 5% cream is used for treating basal cell skin cancer, and is the first breakthrough in thirty years. While most skin cancer treatment has focused on their surgical removal, this topical takes another approach. Applied five times a week to the area of the superficial basal cell cancer, this cream produces an inflammation of the skin. This triggers the body’s immune response, producing substances that attack viruses and pathogenic mutations like cancers.

What cancers does it treat?

Originally designed to treat genital warts, it was approved for the treatment of actinic keratosis. Actinic keratosis is characterized by red scaly spots, common in fair skinned people who have been overexposed to the sun.

Imiquimod is also approved for treatment of superficial basal cell cancers. The superficial type has cancers close to the surface of the skin, where the cream can take effect. Imiquimod is, at this time, not approved for other types of basal cell cancer. However, there is a lot of potential for extended use with further research and development.

The Importance of Self-Examinations:

Melanomas are the most serious and dangerous of skin cancers. However, with early discovery and treatment, it can be cured. The skin is visible, so proper education of the public can greatly reduce risk from melanomas. Moles which develop into melanomas are dark brown or black. Some develop from existing moles, and others from other areas, usually, from sun damaged skin. Remember to visit your dermatologist at the first sign of suspicion.


ABCD,   actinic keratosis,   basal cell cancer,   melanoma,   self-examination,   skin cancer,