SKIN CANCER: IMAGES

This page contains images of various types of skin cancer. It starts with the more common nonmelanoma skin cancers, basal cell carcinoma (BCC) and squamous cell skin cancer (SCSC). These are also referred to as keratinocyte carcinomas. Next, it briefly touches on Merkel cell carcinoma (MCC), a rare cancer. Finally, it ends with a few images of melanoma.

These images are meant to help you recognize the kind of spots that might be concerning. No image bank is comprehensive, and you may have a spot that is concerning to you that doesn’t look like any of these. If that is the case, you should make an appointment to show your mole or lesion to a health care provider.

In general, when looking at spots to identify a potential skin cancer, it’s helpful to ask yourself:

• Is the spot new?
• Is the spot changing?
• Is it unusual—does it look different from your other spots?
• Has the spot been bleeding for a while?
• Has someone suggested you get it checked?

These are all signs that you should have the spot looked at by a health care provider.

As you go through these images, you will see that each image has a thumbnail description. When you click on the image, it will enlarge and show expanded, descriptive text.

BASAL CELL CARCINOMA (BCC)

Basal cell carcinoma (BAY-zuhl-sel karr-suh-NO-muh) has a variable look, and the subtler forms can be tricky to distinguish from other non-cancerous spots you might see on your skin. BCC commonly presents as:

• An open sore that bleeds, oozes, or crusts and remains open for at least two weeks
• A red, raised patch or irritated area that may crust or itch but generally doesn’t hurt
• A shiny pink, red, pearly white, or translucent bump
• A pink growth with a raised border and crusted central indentation
• A scar-like, white, yellow, or waxy area, often with a poorly defined edge
• A darker colored (pigmented), pearly, translucent skin growth. These pigmented basal cell carcinomas are more common in skin of color than they are in light skin
• Ulcerated, which means a portion of the skin that covers the growth is not intact

Below are images that reflect the variation in appearance of BCCs.

SUPERFICIAL BASAL CELL CARCINOMA

Below are images of superficial BCCs, which tend to be flat. It might be easy to miss some forms of BCCs, as they tend to be somewhat subtle and nondescript looking.

NODULAR BASAL CELL CARCINOMA

Nodular BCCs have dome-like parts. Some of these dome-like segments are large, while others are smaller (micronodular). More than half of BCCs will have a nodular appearance.

ULCERATED OR BLEEDING BASAL CELL CARCINOMA

As we have mentioned, BCCs can be ulcerated (meaning the top of the skin is not intact) or actively bleeding. The following images highlight this characteristic.

BASAL CELL CARCINOMA: SPECIAL CASES

Some forms of BCC are less common. Others arise under specific circumstances that are worth noting. Here are a few special cases.

PIGMENTED BASAL CELL CARCINOMA

Pigmented BCCs have a darker color than the typical BCC. The coloration can vary. While they can occur in light-skinned individuals, pigmented BCCs are common in people of color.

SQUAMOUS CELL SKIN CANCER (SCSC) AND THEIR PRECURSORS (PRECANCERS)

Squamous (SKWAY-muhs) cell skin cancers (SCSC) have several characteristics worth noting. They often grow over the course of weeks to months. They vary in size, and they can cause numbness, pain, and muscle weakness if invading a nearby nerve. They may appear as growths, patches, or bumps that are:

• Red and scaly
• Wart-like
• Crusty, itchy, or bleeding
• Ulcerated, which means a portion of the skin is not intact

Some actinic keratoses (ak-TIN-ik ker-uh-TOE-sees) can turn into SCSC. These are described below.

ACTINIC KERATOSES

Actinic keratoses may develop into SCSCs, so it’s important to recognize them. These precancers, also known as solar keratoses, are caused by sun damage. As shown in the pictures below, they often look like small, dry, scaly, or crusty skin patches. Their color varies from dark tan to white to flesh-colored, or they are a combination of colors. They have a rough texture that you can feel.

EARLY SQUAMOUS CELL SKIN CANCER

Early SCSCs are often flat and do not yet have a warty appearance. Look for dry patches that feel rough.

SQUAMOUS CELL SKIN CANCER ON THE FACE

SCSCs can commonly develop on the head area, because of sun exposure. When SCSCs develop on the face, they may be particularly challenging to manage because they can destroy nearby structures or affect nerves. Removing them can be challenging surgically. They can also arise on structures such as the lips. Many people do not realize SCSCs can develop on the lips, so they may confuse them with a cold sore. Again, it’s important to notice if the spot does not heal within two weeks, which raises the suspicion for skin cancer.

SQUAMOUS CELL SKIN CANCER WITH NAIL INVOLVEMENT

Skin cancers, including SCSC and melanoma, can involve the nail. Squamous cell skin cancer can grow under the nail and also damage it. It may even continue to grow and invade the bone. This is one reason it’s important for your health care provider to look at your feet and hands while performing a skin examination.

SPECIAL CASES OF SQUAMOUS CELL SKIN CANCER

Some of the variants of SCSC are shown in this section along with some cases occurring in special locations, such as burn scars or the anus region.

MERKEL CELL CARCINOMA

Merkel cell carcinoma (MUR-kuhl-sel kaar-suh-No-muh) is a rare type of skin cancer that takes the form of a dome-like nodule. It is also sometimes called a neuroendocrine carcinoma of the skin because it arises from the Merkel cells (touch receptors), which are part of the neuroendocrine system. Merkel cell carcinomas are typically fast growing.

MELANOMA

Melanoma (mehl-uh-NO-muh) has been included here for completeness.

Many lesions for melanoma can be judged by the ABCDE rules:
A = Asymmetry (the shape of one half does not match the other)
B = Border (the melanoma has uneven or irregular borders)
C = Color (can be multiple shades of brown or black, and sometimes mixed with white, gray, blue, or red; some may show a loss of pigmentation in or around a preexisting mole)
D = Diameter (often larger than 6 mm in diameter; however, because of increased early detection, 30% of melanomas are less than 6 mm in diameter when they are found)
E = Evolution (the mole has changed or evolved over time)

MELANOMA IN PEOPLE OF COLOR

While people of color are less likely to develop melanoma than lighter-skinned individuals, they can still develop melanoma. In people of color, there is a higher proportion of melanoma cases called acral lentiginous. This type of melanoma occurs on the palms, soles of the feet, or in or below the nails. These are not areas that are typically exposed to the sun. Regardless of your skin color, you should check your hands, feet, and nails for these types of spots. You should also make sure your provider looks at them during any skin checks. Note: It’s important to take off nail polish before inspecting your nails so you can get a clear view.

Watermarked images show the source of the image. The sources for specific non-watermarked images are listed below.
These non-watermarked images are from the following sources: The BCC image that resembles a small scratch is reprinted with courtesy of Saturn Stills/Science Photo Library. The morpheaform BCC image has been obtained courtesy of Creative Commons. This image gallery was reviewed by Dr. Silvina Pugliese, MD, Stanford University.

*The remaining images without a watermark are from various professionals who made their images available to the public as a service via Wikimedia Commons.