Skin cancer has been the most common form of tumor in humans in recent years. The increase in the incidence of the disease since the 60s leads to a doubling of the number of cases every 10 years.
This trend affects not only the so-called "white skin cancer", but also extremely dangerous malignant melanomas ("black skin cancer"). At the same time, no other human organ can be examined as simply and at the same time as effectively as the skin.
Since early detection of skin cancer is almost always highly curable, prevention with early diagnosis is of paramount importance in dermatology. Recommended examination intervals depend on the patient's respective risk profile. This risk profile is established at the first examination.
In our dermatological clinic, we use modern computer systems for skin cancer analysis (digital video dermatoscopy in incident light). These systems make it possible to accurately recognize skin changes according to your predisposition to various forms of rebirth.
In this way, unnecessary operations can be avoided or their necessity confirmed. The images are stored in a digital format and, using special programs that analyze the images (body mapping), they are subject to comparison as part of the ongoing monitoring of treatment. The system recognizes newly developed pigment deposits, as well as every change in already existing pigment and birthmarks.
Operative dermatology is the main specialization of the clinic. Prof. Dr. Dirschka is one of the leading dermatologists in Germany and is a member of renowned professional associations, including the dermatological community. As a member of the trade union of German dermatologists, Professor Thomas Dirschka actively represents the interests of German dermatologists and regularly leads operational training courses for dermatologists.
All operations are performed by a team of surgeons according to the best modern standards. We offer the following surgeries:
- plasty with the nearest flap (displaceable flap, folding flap, rotational flap)
- plasty with a distant flap
- free grafts for covering tissues in tumor surgery
- abrasion of skin layers
- laser skin resurfacing
The main goal is to achieve the best results with the best aesthetic effect.
Malignant melanoma is a cancer of the pigment-forming skin cells (melanocytes). In 70% cases it occurs on normal, unremarkable skin, in 30% cases it occurs on existing moles. Currently, the incidence of cancer in Germany is increasing annually by 8%. Malignant melanoma is one of the fastest growing forms of cancer.
Risk factors for malignant melanoma:
- ultraviolet irradiation (sun, solarium)
- light skin type
- skin burns in childhood
- place of residence for fair-skinned people (proximity to the equator)
The tumor is characterized by diverse clinical forms, which differ depending on the type and localization.
First diagnosis of malignant melanoma:
A - assymetry, asymmetry
B - border irregularity, fuzzy borders
C - color, varying color
D - diameter, diameter is more than 5 mm
E - evolving, bulge
Particularly important for the accurate diagnosis of malignant melanoma is reflected light microscopy, which we use as digital computerized epiluminescent dermatoscopy. This method improves the accuracy of diagnosis.
Treatment of malignant melanoma is carried out promptly and is significantly set depending on the depth of penetration of the tumor, which determines the capture distance. When the tumor expands by more than 1 mm, the so-called sentinel elimination of the lymph node is recommended.
Basal cell carcinoma
Basal cell carcinoma is the most common malignant tumor in whites. The main risk factor is lifetime exposure to the sun. Basal cell carcinoma occurs mainly on areas of the skin exposed to the sun (nose, nasolabial folds, auricles, cheeks, scalp), as well as on the areas of the trunk and extremities (basalioma of the skin of the trunk). The tumor does not metastasize, however, it has the ability to penetrate into adjacent, deeper tissue structures. Clinically, this tumor is characterized by a shiny, "pearl" surface with dilated blood vessels.
Treatment is determined based on the size and location of the tumor. Since in large tumors and special growth forms of basal cell carcinoma it is difficult to determine the depth and sides of the stretch, a special operative technique, micrographic-guided surgery, is used to ensure complete elimination of the tumor. Treatment of basal cell carcinoma also includes photodynamic therapy and topical therapy (in certain forms) with imiquimod
Actinic keratosis is an early form of white skin cancer. It occurs under the influence of ultraviolet radiation from the sun, mainly in fair-skinned people with increased susceptibility to ultraviolet radiation. About 10% cases of actinic keratosis progress to invasive squamous cell carcinoma (an aggressive form of white skin cancer). Therefore, early and thorough diagnosis and treatment are of particular importance.
Small bumps first appear on exposed areas of the skin (face, hairless part of the head) and can often be misdiagnosed as minor lesions or "aging skin". If skin changes develop further, association of several different actinic keratoses may occur.
Actinic keratosis occurs through a "multi-step mechanism". First, tumor cells develop in the lower layers of the epidermis, which, with subsequent development, penetrate the entire outer layer of the skin. In this case, the so-called in-situ carcinoma occurs.
Head of the Clinic of Dermatology, Oncodermatology and Allergology