Volume 19 ; Issue 1 ; in Month : 2026 (2026) Article No : 141
Kumar S, Kumar P, Fazal B, et al.

Abstract

Skin cancer comprises a heterogeneous group of malignancies with markedly different biological behavior, ranging from locally destructive but usually slow-growing basal cell carcinoma (BCC) and potentially metastatic cutaneous squamous cell carcinoma (cSCC) to melanoma, the most aggressive major cutaneous malignancy. The attached thesis identifies ultraviolet (UV) radiation as the principal modifiable driver and reviews the contributions of phenotype, genetic susceptibility, immunosuppression, chronic inflammation and carcinogen exposure. It also describes the transition from conventional clinical examination and biopsy toward dermoscopy, total-body photography, reflectance confocal microscopy, ultrasound, spectroscopy, electrical bio-impedance, tape stripping, multispectral imaging and computer-assisted analysis. This review updates that framework using contemporary evidence and emphasizes the clinical integration rather than the replacement of histopathology by emerging technologies. UV-associated DNA damage, oxidative stress and disruption of tumor-suppressor and oncogenic signaling form the biological basis of carcinogenesis. BCC is strongly associated with aberrant Hedgehog signaling, whereas melanoma commonly involves MAPK-pathway alterations including BRAF and NRAS. Treatment is stage- and subtype-dependent: surgery remains the principal curative treatment for most localized tumors, while advanced melanoma is managed increasingly with immune-checkpoint inhibitors and molecularly targeted therapy; advanced BCC and cSCC also have effective systemic targeted and immune-based options. Artificial intelligence (AI) can augment image interpretation, but external validation, dataset diversity, clinical workflow integration and explainability remain important limitations. Prevention through UV avoidance, protective clothing, shade and broad-spectrum sunscreen is a high-value population strategy. A future model of skin-cancer care will combine risk-adapted surveillance, multimodal non-invasive imaging, pathology and molecular profiling with individualized treatment and long-term prevention.

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