Skin cancer is the most common cancer in the United States — about 1 in 5 Americans will develop one by age 70. Caught early, it is also among the most curable. At Fayetteville Dermatology, Dr. James Prezzano — a board-certified dermatologist and fellowship-trained Mohs surgeon — handles the full journey in one office: skin checks, biopsy, diagnosis, and surgical treatment for patients across Central New York.
The Main Types of Skin Cancer
Basal cell carcinoma (BCC) is the most common type, making up roughly 8 in 10 skin cancers. It typically appears as a pearly bump, a pink patch, or a sore that heals and reopens — most often on the face, ears, scalp, and neck. BCC grows slowly and very rarely spreads, but it does keep growing locally and can become destructive if ignored.
Squamous cell carcinoma (SCC) is the second most common type. It often looks like a rough, scaly, or crusted bump that may be tender or bleed. Unlike BCC, SCC can spread to lymph nodes if left untreated for a long time — which is why timely treatment matters. Dr. Prezzano has co-authored peer-reviewed research on how Mohs surgeons grade squamous cell carcinoma.
Melanoma is less common but the most serious type, because it can spread early. It usually appears as a new dark spot or a changing mole. Found early, melanoma is highly treatable — which is why regular skin checks and prompt evaluation of changing moles are so important.
Actinic keratoses (AKs) are precancerous rough, scaly patches caused by sun damage. A small percentage progress to squamous cell carcinoma over time, so we treat them before that can happen.
Warning Signs: When to Get a Spot Checked
Have a spot evaluated if you notice any of the following:
- A sore or pimple-like bump that doesn't heal within 3-4 weeks, or heals and reopens
- A spot that bleeds, itches, crusts, or becomes tender without a clear cause
- A new dark spot appearing in adulthood, or a mole that is changing
- The ABCDEs of melanoma: Asymmetry, irregular Borders, uneven or multiple Colors, Diameter larger than a pencil eraser, and Evolving size, shape, or color
- A rough, scaly patch that keeps coming back in the same sun-exposed spot
Most spots people worry about turn out to be benign — but the only way to know is to have it examined. A quick look is always better than waiting.
How We Diagnose Skin Cancer
Diagnosis starts with a focused exam of the spot in question (or a full-body skin exam if you're due for one). Dr. Prezzano uses dermoscopy — a polarized magnifying lens — to evaluate structures beneath the skin surface that aren't visible to the naked eye.
If a spot looks suspicious, a small biopsy is taken during the same visit, under local anesthetic. The sample is examined by pathology, and results are usually back within 1-2 weeks. We contact you with the result either way — you won't be left wondering.
Skin Cancer Treatment Options at Fayetteville Dermatology
The right treatment depends on the type of cancer, its size and location, how aggressive it appears under the microscope, and your overall health. Options include:
- Mohs micrographic surgery — the gold standard for skin cancers on the face, head, neck, and other cosmetically sensitive areas, with a cure rate of approximately 99% for previously untreated BCC and SCC. Dr. Prezzano performs Mohs on-site, including same-day reconstruction.
- Surgical excision — removal of the cancer with a margin of healthy skin, usually the right choice for cancers on the trunk, arms, and legs. Performed in-office under local anesthetic.
- Electrodesiccation and curettage (ED&C) — scraping and cauterizing, appropriate for certain small, low-risk BCCs and SCCs.
- Topical treatments — prescription creams (5-fluorouracil, imiquimod) for superficial cancers and actinic keratoses.
- Cryotherapy — freezing, used mainly for actinic keratoses.
Dr. Prezzano will walk you through why a particular option fits your situation — including when a simpler, less expensive treatment is the better choice.
Why Patients Choose Dr. Prezzano for Skin Cancer Care
Dr. James Prezzano is board-certified in both Dermatology and Micrographic Dermatologic Surgery and completed his residency and fellowship at the University of Rochester Medical Center. He has co-authored peer-reviewed research on squamous cell carcinoma grading among Mohs surgeons.
What that means in practice: the doctor who examines your spot is the same one who biopsies it, interprets the findings with pathology, performs the surgery, and does the reconstruction. There is no handoff between a screening clinic, a surgical center, and a plastic surgeon — and appointments are typically available within a week.
After Treatment: Follow-Up and Prevention
Once you've had one skin cancer, your risk of developing another is meaningfully higher — roughly 4 in 10 patients develop a second one within five years. We'll set a surveillance schedule that fits your history, typically a full-body skin exam every 6-12 months.
Day to day, prevention is simple and worth doing: broad-spectrum SPF 30+ on exposed skin (including ears and scalp), reapplied when outdoors for long stretches, plus hats and shade during peak hours. Central New York summers on the lake count just as much as beach vacations.
Frequently Asked Questions
Yes. Skin exams, biopsies, and skin cancer surgery — including Mohs — are covered by Medicare and most major insurance plans, including Aetna, BCBS, Cigna, and United Healthcare. Contact our office if you'd like help confirming your coverage.
For most adults, once a year is reasonable. If you've had a skin cancer before, have many moles, or have significant sun damage, Dr. Prezzano may recommend every 6 months. Patients with a history of melanoma follow a closer schedule.
We'll call you to explain exactly what was found and what it means, then schedule the appropriate treatment — often within 1-2 weeks. For most patients that means an in-office procedure under local anesthetic, either Mohs surgery or a standard excision depending on the type and location.
Most skin cancers are highly curable when caught early. Mohs surgery cures approximately 99% of previously untreated basal cell and squamous cell carcinomas. Even melanoma has excellent outcomes when found at an early stage — which is why prompt evaluation matters.
With a skin biopsy — a small sample taken in the office under local anesthetic, usually in just a few minutes. Results are typically back within 1-2 weeks, and we contact you with the result either way.
It varies by type. Basal cell carcinoma often looks like a pearly bump or a sore that won't heal; squamous cell carcinoma tends to be rough, scaly, and tender; melanoma usually appears as a new or changing dark spot. If a spot is new, changing, bleeding, or simply doesn't look like your other spots, have it checked — most turn out benign, but an exam is the only way to know.
Schedule Your Mohs Consultation
If you've been diagnosed with a skin cancer — or your primary care provider or another dermatologist has recommended Mohs surgery — we typically have appointments available within the same week.
We accept most major insurance plans including Aetna, BCBS, Cigna, United Healthcare, and Medicare.
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