Feet are covered in skin and need protection just like the rest of your exposed body parts. I admit I have been guilty of slathering SPF on my shoulders and missing my feet causing a sun burn on the top of them. This is not only painful, but also creates increased risk for skin cancer of the foot. Studies show that about 90 percent of non-melanoma skin cancers and 65 percent of melanoma cases are associated with exposure to ultraviolet (UV) radiation from the sun. Yes, skin cancers of all types can occur on your feet.
Being in practice for over 10 years, I have diagnosed and treated several patients with skin cancers on their feet. The most common forms of skin cancer on the foot are basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. Patients often present with skin lesions that appear rather benign. Some lesions are painless and do not behave or look like we, the patient or the doctor, expect. Some skin cancers result from long standing ulcerations or wounds on the foot and ankle which may be very painful. These can develop into a cancerous lesion, causing it not to heal. Moreover, skin cancers on the foot can go misdiagnosed as blisters, calluses, moles, chronic dry skin, bruises, athlete’s foot, warts, or ulcers.
Recently, a patient presented to our office with a spreading skin lesion that was red, scaly and had drainage between the 1st and 2nd toes. She has been prescribed creams and treatments from other physicians, and it was not responding. It resembled tinea pedis (athlete’s foot) with the exception that the surrounding skin edges were very irregular. It just didn’t look like a typical rash. A simple biopsy done that same day in the office confirmed a few days later that the lesion was malignant melanoma. She was immediately referred for treatment to a surgical oncologist. The patient, Ms. Anne Agee stated, “Everyone should get a second opinion when things aren’t getting better. If it hadn’t have been for Dr. Smith, I might not be alive today.” That certainly is true, as the survival rate for those with advanced malignant melanoma is only 15 percent.
Prevention of skin cancer on the feet and ankles is similar to any other body part: limit sun exposure, apply appropriate sunscreen, and check your body for suspicious lesions. With Memphis’ warm climate, we are more susceptible to sun exposure on our feet throughout the year, thus increasing risk of skin cancer. In fact, one or more blistering sunburns in childhood or adolescence can more than double a person’s chances of developing melanoma later in life.
Seek medical treatment sooner rather than later if you have a suspicious lesion on your foot, ankle, or any area of your skin. Suspicion for skin cancer should arise if you have a lesion that has irregular borders, is uneven in color, is quickly growing, has been present for a long period of time, is recurring in the same spot, or is not getting better with the usual treatment. If you have a skin lesion or wound on your foot or ankle that is suspicious, it may be time for a biopsy. A simple “punch” biopsy can be done in the office under local anesthesia to determine an accurate diagnosis. An accurate diagnosis can lead to earlier treatment and resolution before it becomes life or limb threatening.
This basal cell carcinoma resembles a wart or callus.
This patient was concerned about a bruise on her toe. A biopsy revealed malignant melanoma.
This recurring blister was diagnosed as squamous cell carcinoma.
Lesions such at this could be a wart, chronic athlete’s foot, a callus, or a skin cancer.