~ Signs & Symptoms ~

Learning Outcomes:

Differentiate between signs and symptoms in the context of skin cancer.
Identify common early signs of skin cancer, including changes described by the ABCDE rule (asymmetry, border, colour, diameter, evolution).
Describe common signs and symptoms of basal cell carcinoma.
Describe common signs and symptoms of squamous cell carcinoma.
Describe signs and symptoms of melanoma.
Recognize body areas where skin cancer most commonly appears.
Understand the importance of detecting changes in moles or skin growths for early identification of skin cancer.

Overview

Learning the signs and symptoms of common skin cancers can be an important part of recieving an early diagnosis. Learn to differentiate between a normal mole and a malignant lesion by examining the signs and symptoms of basal cell carcinoma, squamous cell carcinoma, and melanoma.

Definition: Signs

Objective evidence of a disease (ex. new skin growth).

Definition: Symptoms

Subjective evidence of a disease (ex. abdominal pain).

General Signs & Symptoms

Many types of skin cancer exist, though most have very similar signs and symptoms associated with them.¹ Skin cancers commonly occur on parts of the body that experience direct sunlight, such as the scalp, face, arms, and ears.¹ It is important to catch skin cancer early, as it can spread to nearby tissues if not caught.²

Common signs and symptoms of skin cancer include:¹

New growths on skin that look like a mole, bump, or scab.
A rough patch on the skin.
A sore on the skin that won't heal, looks crusty, has a depression in the middle, or bleeds often.
Changes to a mole or freckle, such as getting bigger or changing colour.
Itchiness around skin growth.
Pain around the growth.

Make an appointment with a healthcare provider if you notice any of these signs/symptoms.²

The ABCDE Rule

This rule tells you what signs to look out for if you find a skin growth:²

A ➡️ Asymmetry, irregular shape

B ➡️ Blurry or irregularly shaped edges

C ➡️ Colour or more than one colour on mole

D ➡️ Diameter is larger than a pencil eraser (6 mm)

E ➡️ Evolution, enlarging, changing in shape, colour or size*

*This is the most important sign of skin cancer.

Basal Cell Carcinoma

This cancer usually develops around the head, face, and neck, though it can also be found on the central part of the body.³ Signs and symptoms associated with this type of cancer include:³

Pale white or yellow flat areas that look like scars.
Rasied or scaly red patches.
A sore that doesn't heal or comes back after healing.
Small, smooth and shiny lumps that are pearly white, pink, or red and may have blue, brown, or black areas.
A pink growth with raised edges and indents in the centre.
A growth that has small blood vessels (telangiectasia) or the surface and/or bleeds.
A growth that is itchy.
Hyperpigmentation.

Squamous Cell Carcinoma

Like basal cell carcinoma, squamous cell carcinoma also occurs on areas of the skin that are exposed to the sun.³ However, it can also be found arounf the genitals and anus.³ Signs and symptoms include:³

A sore that doesn't heal or comes back after healing.
Rough or scaly red patches with irregular borders.
Raised lumps that indent in the centre.
A growth that looks like a wart.
A sore that is crusty or bleeds easily.

Melanoma

While this form of skin cancer is less common, it is much more deadly than both basel cell carcinoma and squamous cell carcinoma.⁴ It most commonly forms on the skin, but can also occur in the oral and anogenital mucosal surfaces, the esophagus, the meninges, and the eye.⁴ This cancer is often asymptomic, making early detection challenging.⁴ Some common signs and symptoms include:

Skin growths with striking variations in pigmentation (black, brown, red, grey, dark blue).
Rapid enlargement of a preexisiting nevus.
Itching or pain in a lesion.
Development of new pigmented lesion during adult life.

Prevention & Detection

Checking your skin on a regular basis can help with early detection.⁵ By checking regularly, you can become familiar with what is normal for your skin and catch when something goes wrong.⁵

How to check your skin:⁵

Ensure you are in a well-lit room.
Use a larger mirror so you can look closely at your entire body.
Raise your arms and look at the right and left sides of your body in the mirror, look at your hands, each finger and fingernail, and the spaces between your fingers.
Look at the back, front, and sides of your legs, as well as the tops and soles of your feet, toenails, and the spaces between your toes.
Check your genital area and between your buttocks.
Look at yout face, neck, back of your neck, and scalp.

If you notice any of the signs or symptoms listed above, tell your doctor immediatly.

Prognosis

If skin cancer is caught and treated early, the chances of successful treatment is better.⁵ Doctors use staging and grading (see "Pathogenesis") to determine prognosis.⁶ Basal cell carcinomas are slow-growing and do not metastasize, so prognosis is generally good.⁴ Squamous cell carcinoma are also generally not metastatic and can be easily resected, making prognosis good overall.⁴ Melanomas, on the other hand, are capable of metastasizing, resulting in a poorer prognosis than other forms of skin cancer.⁷ However, there are many factors that play a role in the prognosis of this cancer, so it is recommended to go to a trusted healthcare practitioner for accurate prognosis.⁷

Podcast

281b5606.mp3

Test Your Knowledge

What is the most common warning sign of skin cancer?

A) Persistent fever

B) Change on the skin such as a new growth or change in a mole

C) Sudden hair loss

D) Swelling in the joints

Which if the following is considered a sign of skin cancer rather than a symptom?

A) Pain around a skin growth

B) Itching around a skin lesion

C) A new growth on the skin

D) Burning sensation on the skin

According to the ABCDE rule, which letter represents changes in a lesion over time?

A) A - Asymmetry

B) B - Border

C) C - Colour

D) E - Evolution

A patient reports itching around a mole that has not visibly changed in size or colour. According to the provided information, this symptom should be interpreted as:

A) A definitive diagnosis of melanoma

B) A possible early manifestation of melanoma

C) A symptom unrelated to skin cancer

D) Evidence of a benign skin growth

Which of the following clinical findings would MOST strongly suggest melanoma rather than non-melanoma skin cancer?

A) Rough, scaly red patch

B) Pearly nodule with raised blood vessels

C) Rapid enlargement of a pigmented nevus with irregular borders

D) Wart-like growth on sun-exposed skin

Which of the following features is characteristic of basal cell carcinoma?

A) Rough scaly patch taht resembles a wart

B) Raised nodule or papule with rolled edges and visible vessels

C) Large painful ulcer that spreads rapidly

D) Yellow blister that bursts easily

Which of the following is a common sign of squamous cell carcinoma?

A) Rough to scaly red patch with irregular borders

B) Smooth mole with uniform borders

C) Flat skin-coloured patch with no texture

D) Clear fluid-filled blister

Skin cancer most commonly occurs on:

A) Areas covered by clothing

B) Sun-exposed areas such as the scalp, face, lips, and ears

C) Internal organs

D) Only the palms and soles

Which of the following is included in the ABCDE rule for identifying melanoma?

A) Density

B) Elevation

C) Elasticity

D) Evolution

A patient notices a mole that has recently become larger and developed multiple colours including brown, black, and red. The borders appear irregular. Which warning sign of melanoma is BEST represented in this scenario?

A) Diameter

B) Colour variation

C) Asymmetry

D) Evolution

Answer Key

References

1. Mayo Clinic Staff. Skin Cancer [Internet]. Mayo Clinic. 2025. [cited 2026 April 10]. Available from: https://www.mayoclinic.org/diseases-conditions/skin-cancer/symptoms-causes/syc-20377605

2. Cleveland Clinic Staff. Skin Cancer: Symptoms, Types & Treatment [Internet]. Cleveland Clinic. 2023. [cited 2026 April 10]. Available from: https://my.clevelandclinic.org/health/diseases/15818-skin-cancer

3. Bobotsis R. Signs and symptoms of non-melanoma skin cancer [Internet]. Canadian Cancer Society. 2024. [cited 2026 April 10]. Available from: https://cancer.ca/en/cancer-information/cancer-types/skin-non-melanoma/signs-and-symptoms

4. Kumar Vinay, Abbas AK., Aster JC., Deyrup AT., Das Abhijit, Robbins SL. Robbins & Kumar basic pathology. 11th ed. Philadelphia: Elsevier; c2023. 775–793 p.

5. Canadian Cancer Society. Finding skin cancer early [Internet]. Canadian Cancer Society. 2025. [cited 2026 April 10]. Available from: https://cancer.ca/en/cancer-information/cancer-types/skin-non-melanoma/finding-cancer-early

6. Bobotsis R. Stages of non-melanoma skin cancer [Internet]. Canadian Cancer Society. 2024. [cited 2026 April 10]. Available from: https://cancer.ca/en/cancer-information/cancer-types/skin-non-melanoma/staging

7. Wright F. Prognosis and survival for melanoma skin cancer [Internet]. Canadian Cancer Society. 2023. Available from: https://cancer.ca/en/cancer-information/cancer-types/melanoma-skin/prognosis-and-survival

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