Merkel Cell Carcinoma: Understanding This Rare and Aggressive Skin Cancer

What is Merkel Cell Carcinoma?

Merkel cell carcinoma (MCC) is a rare but highly aggressive form of skin cancer that demands immediate medical attention. Unlike more common skin cancers, Merkel cell carcinoma grows rapidly and has a significant risk of spreading to other parts of the body. This serious condition typically presents as a fast-growing nodule or bump on sun-exposed areas of the skin, making early detection and treatment absolutely critical for positive outcomes.

Named after the Merkel cells found in the top layer of the skin, this cancer develops when these cells begin to grow uncontrollably. While Merkel cell carcinoma accounts for less than 1% of all skin cancer cases, its aggressive nature and potential for metastasis make it one of the most dangerous types of skin cancer.

Recognizing Merkel Cell Carcinoma: Key Visual Characteristics

Understanding what Merkel cell carcinoma looks like can be lifesaving. This aggressive skin cancer has several distinctive features:

Appearance and Color

Merkel cell carcinoma lesions can vary significantly in appearance, which sometimes makes diagnosis challenging. The nodules or bumps may appear:

• Flesh-colored or skin-toned, making them easy to overlook

• Red or pink, resembling other benign skin conditions

• Purple or violet, which may look like a bruise

• Blue or bluish-red in coloration

The wide range of colors means that any unusual growth shouldn't be dismissed based on appearance alone.

Location and Growth Pattern

Sun-Exposed Sites: Merkel cell carcinoma most commonly develops on areas of the body that receive significant sun exposure, including:

• Face and eyelids

• Head and scalp

• Neck and throat area

• Arms and hands

• Legs (less common but possible)

Rapid Growth: One of the most alarming characteristics of Merkel cell carcinoma is how quickly it develops. Unlike many benign skin lesions that remain stable over months or years, MCC typically grows noticeably within weeks to months. This rapid expansion should always trigger immediate medical evaluation.

Physical Characteristics

• Firm, dome-shaped nodule that feels solid to the touch

• Painless in most cases (though some patients report tenderness)

• Smooth or shiny surface

• Size typically ranges from less than 1 inch to several inches in diameter

• May ulcerate or bleed as it progresses

High-Risk Factors: Who is Most Susceptible?

While anyone can develop Merkel cell carcinoma, certain factors significantly increase the risk of developing this aggressive skin cancer:

Skin Type and Sun Exposure

Fair Skin: Individuals with fair skin, light hair, and light-colored eyes have substantially higher risk. The lack of melanin, which provides natural protection against UV radiation, makes fair-skinned individuals more vulnerable to various types of skin cancer.

Chronic Sun Exposure: Years of cumulative sun exposure, particularly without adequate sun protection, damages skin cells and increases cancer risk. This includes both recreational sun exposure and occupational exposure for those who work outdoors.

Demographic Risk Factors

Age: Merkel cell carcinoma primarily affects individuals over 50 years old, with the average age at diagnosis being around 70. However, younger individuals can also develop this condition, particularly if other risk factors are present.

Gender: Men are approximately twice as likely to develop Merkel cell carcinoma compared to women, though the exact reason for this disparity remains under investigation.

Medical History

Previous Skin Cancers: A personal history of other skin cancers, including basal cell carcinoma, squamous cell carcinoma, or melanoma, increases the likelihood of developing Merkel cell carcinoma.

Immunosuppression: People with compromised immune systems face elevated risk, including:

• Organ transplant recipients taking immunosuppressive medications

• Individuals with HIV/AIDS

• People receiving chemotherapy or taking medications that suppress immune function

• Those with certain blood cancers or autoimmune conditions

Merkel Cell Polyomavirus: Research has identified that approximately 80% of Merkel cell carcinoma cases are associated with this common virus, particularly in immunocompromised individuals.

Why Early Detection is Critical

Merkel cell carcinoma's aggressive nature makes early detection a matter of life and death. This cancer has a significantly higher rate of metastasis compared to other skin cancers:

Risk of Spreading (Metastasis)

Even when detected early, Merkel cell carcinoma has approximately a 30% chance of spreading to nearby lymph nodes. If the cancer spreads beyond the lymph nodes to distant organs such as the lungs, liver, bones, or brain, treatment becomes much more challenging and survival rates decrease dramatically.

High Recurrence Rate

Even after successful treatment, Merkel cell carcinoma has a notable tendency to return. Studies show that approximately 40-50% of patients experience recurrence within the first two years after treatment, making long-term monitoring essential.

Warning Signs That Demand Immediate Attention

Seek immediate evaluation from a dermatology provider if you notice:

• Any new growth or bump that appears suddenly and grows rapidly

• A lesion on sun-exposed skin that changes in size, shape, or color

• A painless, firm nodule that develops on the face, head, neck, or arms

• Any skin abnormality that bleeds, ulcerates, or doesn't heal

• A bump that looks unusual compared to other growths on your body

• Multiple unusual growths appearing in a short time period

Diagnosis and Treatment Options

Professional Evaluation

Diagnosing Merkel cell carcinoma requires expert evaluation by an experienced dermatology provider. At My Skin, we perform comprehensive skin cancer screenings and can quickly identify suspicious lesions that require biopsy.

The diagnostic process typically includes:

• Detailed visual examination of the lesion

• Dermoscopy to examine skin structures more closely

• Skin biopsy to confirm diagnosis

• Imaging studies (CT, PET scans) to check for spread

• Lymph node evaluation

Treatment Approaches

Treatment for Merkel cell carcinoma is aggressive and multi-modal, often involving:

• Surgical excision with wide margins to remove all cancer cells

• Sentinel lymph node biopsy to check for spread

• Radiation therapy to eliminate remaining cancer cells

• Immunotherapy for advanced cases

• Chemotherapy when cancer has metastasized

The specific treatment plan depends on the stage of cancer, location, patient health, and whether the cancer has spread.

Prevention and Surveillance

While not all cases of Merkel cell carcinoma can be prevented, you can significantly reduce your risk:

Sun Protection Strategies

• Apply broad-spectrum sunscreen (SPF 30 or higher) daily

• Wear protective clothing, including wide-brimmed hats and long sleeves

• Seek shade during peak sun hours (10 AM to 4 PM)

• Avoid tanning beds and sun lamps entirely

• Consider using UV-protective window film in vehicles

Regular Skin Monitoring

• Perform monthly self-examinations of your entire body

• Schedule annual skin checks with a qualified dermatology provider

• Document any new or changing lesions with photos

• Report any concerning changes immediately

Get Expert Skin Cancer Screening Today

If you have any concerns about unusual skin growths, new bumps, or changing lesions, don't wait. Early detection of Merkel cell carcinoma and other skin cancers can be lifesaving. At My Skin, our experienced team specializes in detecting and treating all types of skin cancer, including rare and aggressive forms like Merkel cell carcinoma.

Leah Michel, APRN FNP-BC, provides thorough skin examinations with 30-minute appointments that allow for comprehensive evaluation of your skin health. We use advanced diagnostic techniques and stay current with the latest developments in skin cancer detection and treatment.

Our practice accepts Medicare, most commercial insurances, and self-pay patients. We have convenient locations in both St. Petersburg and Bradenton, Florida, making expert dermatological care accessible when you need it most.

Don't delay when it comes to your skin health. Schedule an appointment today for a comprehensive skin cancer screening. Early detection saves lives, and we're here to provide the expert care you deserve.

Contact My Skin

St. Petersburg Office:
111 2nd Ave NE, Suite 1406
St Petersburg, FL 33701
Phone: (727) 295-7223

Bradenton Office:
4301 32nd St. W., Suite D2
Bradenton, FL 34277
Phone: (941) 330-5805

Visit myskinstpete.com to learn more about our comprehensive dermatology services and to access patient resources.

Remember: Any new, unusual, changing, or symptomatic skin growth warrants immediate professional evaluation. Your skin health is too important to ignore.