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Number 1 Skin Cancer & Pre-Cancer Care

D. Pre-Cancerous Lesions

Number 1 Skin Cancer & Pre-Cancer Care

A. Skin Cancer Diagnosis

B. Skin Cancer Types

C. Skin Cancer Treatment

D. Pre-Cancerous Lesions

Number 1 Medical Dermatology
(Chronic & Inflammatory Skin Diseases)
Number 3 Pigment & Lesion Disorders
Number 4 Non-Cancer Growth
Number 5 Surgical Dermatology (Non-Cancer Procedures)
Number 6 Cosmetic Dermatology
Metastatic Cancer PDF

• Metastatic Cancers

(When a cancer from another organ spreads to the skin)

1. What Does “Metastatic Cancer” Mean?

Metastatic cancer means a cancer that started in one part of the body (such as the breast, lung, colon, or kidney) has spread to another location.

When metastatic cancer shows up in the skin, it is called a cutaneous metastasis. These are not primary skin cancers like basal cell carcinoma, squamous cell carcinoma, or melanoma—rather, they represent spread from a cancer elsewhere in the body.

2. What Do Cutaneous Metastases Look Like?

Cutaneous metastases most commonly appear as:

  • Firm, round or oval bumps (nodules) in or under the skin

  • Often painless (though they can be tender)

  • Skin-colored, pink, red, purple—or blue/black in some melanoma metastases

  • Sometimes multiple lesions appear quickly

  • Occasionally they can ulcerate (break down) or resemble an infection/rash

They often develop near the original cancer site, but can appear elsewhere.

A classic example

A firm nodule at the belly button can be a Sister Mary Joseph nodule, which is an umbilical metastasis from an internal cancer (often gastrointestinal or gynecologic).

3. Which Cancers Most Commonly Spread to Skin?

Cutaneous metastases are uncommon overall, but when they occur, common sources include (patterns differ by sex):

  • Breast, colon, melanoma, ovarian (more common in females)

  • Lung, colon, melanoma (more common in males)

Important: Sometimes a skin metastasis can be the first sign of an undiagnosed internal cancer—so a prompt evaluation matters.

4. How We Diagnose Metastatic Cancer in the Skin

Diagnosis typically requires:

a) Skin exam

We evaluate size, firmness, growth rate, and location.

b) Skin biopsy

A biopsy is essential to confirm the diagnosis.

c) Special pathology testing

Pathologists often use immunohistochemistry to help identify where the cancer likely originated.

d) Care coordination

If metastasis is confirmed, we coordinate with your oncology team (or help connect you with one) for further evaluation and treatment planning.

5. How Cutaneous Metastases Are Treated

Treatment is usually focused on the underlying cancer, often with guidance from oncology. Because skin metastases often indicate systemic disease, treatment frequently involves systemic anti-cancer therapy (with additional local treatments in selected cases).

Dermatology may also help with:

  • Symptom relief (pain, bleeding, irritation)

  • Wound care if ulceration occurs

  • Biopsy and diagnosis to guide next steps

6. Pre-Op Instructions

(Not surgery—these are “before your visit/biopsy” tips.)

Before your appointment

  • Take photos if the lesion changes quickly.

  • Write down:

    • When you first noticed it

    • How fast it’s changing

    • Any history of cancer (type, treatments, dates)

  • Bring a list of:

    • Current medications and supplements

    • Your oncologist’s contact information (if applicable)

If a biopsy may be done

  • Tell us if you take blood thinners or bruise easily.
    ⚠️ Do not stop prescribed blood thinners unless your prescribing clinician instructs you.

  • Tell us about allergies to adhesives, antiseptics, or numbing medicine.

7. Post-Op Instructions

After a skin biopsy

  • Keep the bandage on and dry for 24 hours (unless instructed otherwise).

  • After 24 hours, daily:

    1. Gently clean with mild soap and water

    2. Pat dry

    3. Apply a thin layer of ointment if instructed

    4. Cover with a clean bandage

  • Avoid soaking (pools/hot tubs/baths) until healed.

  • Call if you develop increasing redness, warmth, swelling, pus, fever, or bleeding that won’t stop with pressure.

After results are available

  • If results show metastatic cancer, we will:

    • Review what the biopsy suggests

    • Coordinate next steps with oncology and/or your treating physicians

    • Help guide what additional testing may be needed

8. When to Seek Urgent Care

Seek urgent/emergency care if you have:

  • Rapidly worsening shortness of breath, chest pain, confusion, or severe weakness

  • Uncontrolled bleeding from a skin lesion

  • High fever with rapidly worsening skin pain or spreading redness

Call our office promptly if:

  • A lesion is rapidly enlarging

  • New lumps appear

  • A biopsy site shows signs of infection

Request An Appointment

Frequently Asked Questions

#1

PDT uses a prescription medication plus a specific medical light to activate it. Our office only uses “red light” alone can be used for acne in some settings.

During light exposure, many patients feel stinging, heat, tingling, or burning. We use comfort measures (fans, cooling breaks) as needed.

Most patients have visible redness and irritation for 2–7 days, with peeling that can last up to 10 days, depending on the area and intensity.

Some people can, but many prefer downtime because of redness/peeling. Plan for social downtime of a few days, especially for facial treatments.

PDT can significantly reduce AKs and treat “field” sun damage, but it doesn’t stop future sun damage. Ongoing sun protection and skin checks are key.

PDT is widely used in dermatology. Side effects are usually temporary and localized, most commonly redness, burning, swelling, and peeling.

PDT is commonly used for precancerous lesions (AKs) and some superficial conditions as determined by your dermatologist. Confirmed skin cancers often require other treatments. Your clinician will guide what’s appropriate.

Often yes—especially retinoids and exfoliating acids for several days before and after. We’ll give you an exact list based on your regimen.

Call the office. Light exposure too soon can significantly worsen burning and irritation. Cover up immediately and follow our instructions.