A new study led by Gil Yosipovitch from the Department of Dermatology at Temple University School of Medicine reveals that doctors who ask patients if a suspicious skin lesion is painful or itchy can make better decisions on whether the spot is likely to be cancerous.
The study, published online by JAMA Dermatology on July 23, 2014, found that nearly 36. 9 percent of skin cancer lesions are accompanied by itching, while 28.2 percent involve pain. Non-melanoma skin cancers — specifically, basal cell carcinoma and squamous cell carcinoma — are more likely than melanoma to involve itch or pain, the study found.
"The study highlights the importance of a simple bedside evaluation for the presence and intensity of pain or itch as an easily implementable tool for clinicians in evaluating suspicious skin lesions," concluded the study. Dr. Yosipovitch, Director of the Temple Itch Center, said the findings are important because skin cancer is the most common cancer in the United States.
• The prevalence of itch was greatest in squamous cell carcinoma (46.6 percent), followed by basal cell carcinoma (31.9 percent) and melanoma (14.8 percent).
• Pain prevalence was greatest in squamous cell carcinoma (42.5 percent), followed by basal cell carcinoma (19.9 percent) and melanoma (3.7 percent).
• Pain and itch often went hand in hand: 45.6 percent of lesions associated with itch also had pain; and 60 percent of painful lesions also involved itch.
• The most painful lesions tended to be those with the greatest depth (except for melanoma lesions, which did not correlate with pain). Pain and itch was also associated with lesions that were larger in diameter. Cancers that were ulcerated (sores or open wounds) tended to be associated with pain but not with itch.
• Pain and/or itch were more likely to be present when the laboratory analysis of the skin lesion sample suggested a marked or moderate degree of inflammation as compared to mild or no inflammation.
Dr. Yosipovitch said he hopes the study findings will prompt dermatologists to incorporate the use of a ranking scale for pain and itch when evaluating patients with suspicious skin lesions. This could increase the detection of skin lesions that are cancerous," he said.