The dermis ● The papillary layer is where blood vessels, touch receptors, and capillaries reside. This layer connects the dermis to the epidermis and forms the epidermal junction. ● The reticular layer supplies the skin with nutrients and oxygen and is composed of the base of hair follicles, blood and lymph vessels, glands, nerve endings, and collagen and elastin. Hyaluronic acid is also naturally present here.
triglycerides, and other essential lipids are produced to form the skin’s barrier function. ● Stratum spinosum is where enzymes create proteins and lipids, along with immune cells that protect the body from infection and determine foreign material that does not naturally occur. ● Stratum germinativum is the bottom layer of the epidermis and is also referred to as the basal layer. This is where cell division begins and where melanocytes produce melanin. This is also where sensory cells and touch receptors reside. Identifying skin types with the Fitzpatrick Scale Skin types are genetically determined, and treatments should be considered along with the Fitzpatrick Scale, which classifies skin tone and response to UV exposure (Hobbs, 2022). Developed by Dr. Thomas Fitzpatrick, the scale helps guide safe treatments like peels and lasers. Lighter tones
are more sensitive, while darker tones have more melanin protection. The Fitzpatrick Scale The Fitzpatrick Scale is composed of six skin types (Woodrow, 2019):
Type Appearance
Reaction to Sun Exposure Always burns, never tans
I
Very fair skin, light/blonde/red hair, light eyes, freckles
II
Fair/pale skin, light hair/eyes, some freckles
Burns easily, tans minimally
III IV
Fair to beige skin, varied eye/hair colors
Sometimes burns, gradually tans
Olive or Mediterranean skin, dark hair/eyes
Rarely burns, always tans
V
Naturally tan or Middle Eastern skin, dark hair/eyes
Rarely burns, tans very easily
VI
Deeply pigmented brown/black skin, dark hair/eyes
Rarely or never burns, darkens quickly
PART 2: RISK FACTORS FOR SKIN CANCER AND HOW SKIN CANCER OCCURS Risk factors are circumstances that can increase the chances
Conversely, not having any risk factors does not mean skin cancer cannot eventually show up. However, the more risk factors present, the higher the risk.
of getting skin cancer, but identifying any number of risk factors does not guarantee a skin cancer diagnosis.
Risk factors for all skin cancers Exposure to artificial sunlight
especially dangerous, significantly increasing the chance of developing skin cancer in adulthood. ● Fitzpatrick Types I and II Those at the lower end of the Fitzpatrick Scale, like Types I and II, are at the highest risk of developing skin cancer (Kaniszewska, 2025). While higher Fitzpatrick Types are at a lower risk than their counterparts, all Having a personal or family history of unusual moles, actinic keratosis, squamous cell carcinoma, basal cell carcinoma, melanoma, or familial dysplastic nevus syndrome increases the risk of developing skin cancer at a higher rate. Also, changes in genetics or hereditary syndromes are specifically linked to skin cancer. ● Other risks Fitzpatrick Types can develop skin cancer. ● Having a history of skin abnormalities The chance of developing skin cancer increases with age. Consistent skin inflammation present for a long period of time, a weakened immune system, and past treatments with radiation can also increase the risk. ● Squamous cells are flat cells in the upper layer of the epidermis, the stratum corneum, and regularly shed as new cells form. When squamous cells grow irregularly, they can develop into squamous cell carcinoma (American Cancer Society, n.d.a.).
Tanning beds produce artificial UV sunlight to speed up the process of darkening the skin. Using tanning beds is one of the biggest risks of developing skin cancer. Tanning bed use before the age of 35 can increase the risk of developing malignant melanoma by 75% (UnityPoint Health, n.d.). Exposure to natural sunlight Spending time in natural sunlight increases the risk of skin cancer, but it is still possible for unexposed areas of skin to develop skin cancer. Wearing SPF helps protect our skin from UV rays. Many people do not apply enough sun protection and do not reapply it as frequently as needed for proper UV shielding. Having a history of sunburns When ultraviolet radiation from the sun reaches the skin, it damages the skin cells and causes mutations in their DNA (Van Thomme & Bramlet-Blackburn, 2024). Even one sunburn raises skin cancer risk, and repeated or blistering burns increase it further. Childhood sunburns are How skin cancer occurs Skin cancer occurs when uncontrolled cells reproduce in an abnormal way, caused by damaged DNA, which triggers cell mutation. These mutations cause skin cells to multiply rapidly and form malignant tumors. This occurs within the epidermis, where the most common skin cancers develop due to cell mutation of one of three specific types of cells: squamous cells, basal cells, and melanocytes.
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Book Code: ENC0826
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