Basics of skin cancer: Types, diagnosis, and current challenges.

Abstract

Skin cancer is one of the most prevalent malignancies worldwide, with increasing incidence due to factors such as excessive ultraviolet (UV) radiation exposure, genetic mutations, and immunosuppression. It is broadly classified into melanoma and non-melanoma types, with melanoma being the most aggressive and lethal form. Recent advances in understanding the molecular pathogenesis have highlighted key signalling pathways such as MAPK, PI3K/AKT, and Notch, along with mutations in genes like BRAF and p53, contributing to uncontrolled cell proliferation and tumour progression. Non-melanoma skin cancers, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and Merkel cell carcinoma (MCC), present distinct pathological and histological features, yet share overlapping risk factors and challenges in diagnosis and treatment. Despite advances in histopathology, imaging technologies like confocal laser microscopy, optical coherence tomography, and high-frequency ultrasonography, as well as artificial intelligence-based models, early detection remains a significant hurdle, especially in darker skin types where presentation differs. Treatment efficacy is further complicated by the skin's complex biological barriers, drug resistance mechanisms, and the tumour microenvironment (TME), which impedes therapeutic delivery and immune responses. Emerging nanotechnology, novel biosensors, and AI-driven diagnostic tools hold promise for overcoming these barriers, offering potential for more precise, non-invasive detection and targeted therapies. Nonetheless, challenges such as high recurrence rates, treatment-associated toxicities, and substantial healthcare costs persist. A comprehensive understanding of skin cancer's molecular mechanisms, improved diagnostic accuracy, and development of innovative therapeutics remain critical for improving patient outcomes and reducing the global burden of skin cancer.