Malignant melanoma skin cancer - early detection by board certified dermatologist

This Is Skin Cancer?

 

Why pimples and sores that won't heal may be more serious than you think

Melanoma awareness campaigns have done a fantastic job educating the public on the classic ABCDEs — Asymmetry, Border irregularity, Color variation, Diameter, and Evolution. These signs are crucial for identifying potential skin cancers early. But there's a catch: many early skin cancer signs don't fit neatly into these categories, leading them to be dangerously overlooked.

Many people have skin lesions that could be cancerous but don't exhibit the telltale ABCDE features. These lesions may seem benign — like pimples or sores that never seem to heal — and so they get brushed off as nothing serious. But they could be early signs of skin cancer, and ignoring them can have dangerous consequences. The following real cases illustrate why it's essential to pay attention to more than just the ABCDEs.

Real Cases: When Skin Cancer Doesn't Look Like Skin Cancer

Case 1: The Non-Healing Ulcer

A patient came in with a sore on his back that wouldn't heal. He'd been scratching it — it would heal briefly, only to return. This had been going on for months. Upon closer inspection, it turned out to be a melanoma — specifically an amelanotic melanoma, meaning it lacked typical pigmentation. Instead, it appeared as a stubborn ulcer with no color. This is a critical red flag: melanoma can sometimes look like a non-healing sore, especially when it's devoid of the expected dark pigment.

Case 2: The Painful Pimple

A man in his 50s came in with what he thought was a pimple on his hand — present for months, painful, and unresponsive to self-treatment. Upon examination, it was a raised, red lesion with a crust at the center: classic signs of squamous cell carcinoma (SCC), a serious skin cancer that can spread. SCC often presents as a painful bump or nodule and can grow quickly if ignored. Fortunately, he came in early enough for treatment — delayed attention can lead to metastasis.

Case 3: A Persistent Pimple on the Ear

Another patient had a persistent pimple near his ear that would heal, then return and crust up again. This recurring pattern is commonly seen in squamous cell carcinoma, which can develop as a skin-colored bump with a keratin-filled horn or a central ulcer. A lesion that repeatedly heals and reopens — especially with crusting or bleeding — may not be a harmless blemish. It could be skin cancer.

Case 4: A Sore on the Foot

During a routine skin check, a woman was wearing a Band-Aid on her ankle — she assumed her new sandals had caused irritation. Removing it revealed a non-healing sore with a hint of pigment around the edges. It was melanoma of the foot. This case highlights a frequently overlooked area: melanoma can develop anywhere on the body, including the feet, where it's rarely expected and often missed.

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Warning Signs to Never Ignore

⚠️ See a Dermatologist If You Notice:

  • A pimple, bump, or blemish that has been present for more than a few weeks
  • A sore or ulcer that repeatedly heals and reopens
  • Any lesion that crusts, bleeds, or won't fully resolve
  • A painful bump or nodule that doesn't respond to self-treatment
  • Any unusual skin change on commonly overlooked areas — feet, ears, back, or scalp

🩺 The Bottom Line

Not all skin cancers follow the ABCDE pattern. Melanoma, squamous cell carcinoma, and basal cell carcinoma can all show up as ordinary-looking pimples, sores, or ulcers. Early detection is key. If you've been ignoring a blemish or sore that's sticking around longer than it should, make an appointment with your dermatologist today. It's always better to get it checked out than to wait and risk missing an early diagnosis.

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Dr. Yuval Bibi, MD/PhD

Board Certified Dermatologist

Thanks for reading and God bless.

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