Chart — Med-Surg
Skin Cancer Comparison Chart
Three skin cancers, very different stakes. Two are common and mostly local; melanoma is the one that spreads and kills. Appearance and metastatic risk are what separate them.
Educational use only. Appearance varies and biopsy confirms the diagnosis. Any new, changing, or non-healing lesion warrants dermatology evaluation. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
The Three Side by Side
| Feature | Basal cell (BCC) | Squamous cell (SCC) | Melanoma |
|---|---|---|---|
| Frequency | Most common skin cancer | Second most common | Less common but deadliest |
| Appearance | Pearly, translucent papule with rolled borders, telangiectasias; may ulcerate | Scaly, crusted, or ulcerated firm red lesion/nodule | New/changing pigmented lesion; ABCDE features; 'ugly duckling' |
| Common location | Sun-exposed — face, nose, ears | Sun-exposed — face, ears, lips, dorsal hands | Anywhere — back, legs; also acral (palms/soles/nails) and mucosa |
| Growth / spread | Slow; rarely metastasizes (locally destructive) | Can metastasize, esp. immunosuppressed | Can metastasize EARLY and widely; depth (Breslow) drives prognosis |
| Key risk factors | Cumulative UV, fair skin | Cumulative UV, immunosuppression, HPV, chronic wounds | Intense/intermittent UV & sunburns, many/atypical moles, family history |
| Treatment | Excision, Mohs surgery, topical for superficial | Excision, Mohs; radiation; check nodes if high-risk | Wide excision + sentinel node biopsy; immunotherapy/targeted for advanced |
Exam Traps
- ✦Pearly papule with rolled borders + telangiectasias = BCC (most common, rarely spreads).
- ✦Scaly/ulcerated lesion on sun-exposed skin or lip = SCC (can metastasize, esp. immunosuppressed).
- ✦New/changing pigmented lesion with ABCDE features = melanoma (deadliest; spreads early).
- ✦Suspected melanoma = excisional (full-thickness) biopsy to measure Breslow depth.
- ✦UV exposure is the main modifiable risk for all three; transplant patients have very high SCC risk.
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with Academy of Medical-Surgical Nurses (AMSN) · Current medical-surgical nursing standards. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →