Melanoma: an overview and more

Melanoma is a skin cancer that arises from a skin cell called a melanocyte, which produces the pigment (melanin) that gives skin its color. Melanoma can appear in different forms, most of the time as a new spot on the skin or as a pre-existing mole that changes in color, size, or shape. Although melanoma is considered the most dangerous type of skin cancer due to its ability to spread rapidly throughout the body, it can be treated early .

Get Medical Information / Alexandra Gordon

Types and symptoms of melanoma

Distinguishing a malignant birthmark from a normal one can be challenging, even for healthcare professionals. This is why a dermatologist should check for any new, altered, or misplaced spots on the skin.

Possible signs and symptoms of melanoma include:

  • Itching or other sensation on the skin such as tenderness or pain.
  • Skin disease that won't heal
  • Bleeding or oozing from a mole
  • Change in the surface of a mole in the form of a lump or lump
  • Spread of pigment from the edge of the mole to the surrounding skin.
  • Redness or swelling around the mole.

But this list is limited. The way melanoma manifests itself also largely depends on which of the four main subtypes it belongs to, as each of them has its own characteristics. Any mole that is equal to or larger than the diameter of a pencil eraser should be evaluated.

Surface propagation

It is the most common subtype of melanoma in fair-skinned people. It usually begins with an asymmetrical, patchy, discolored brown or black spot .

Early melanoma. DermNet / CC BY-NC-ND

Nodular melanoma

After superficial melanoma, nodular melanoma is the next most common type of melanoma in fair-skinned people. This melanoma does not grow outward, but vertically (deep in the skin).

Nodular melanoma usually begins with a raised dark or light (pink) patch.

Raspberry lentigo

This subtype of melanoma is most often found on chronically sun-damaged skin areas in the elderly. Lentigo maligna usually begins with an irregular brown or brown patch that grows slowly over the years, forming a larger patch that becomes asymmetric and / or asymmetric. or there are color changes or raised areas.

Acral lentiginous

This subtype represents less than 5% of all melanomas. However, it is the most common type among dark-skinned people .

Acral lentiginous melanoma usually appears on the palms of the hands or soles of the feet as an irregular growth or a raised, thickened patch that changes color or size. It can also appear brown under the fingernail or toenail. or stripe or black stripe.

If melanoma grows and spreads to other parts of the body, it can cause symptoms associated with this spread. For example, melanoma that has spread to the liver can cause jaundice , a yellowing of the skin .
Advanced cancer can also cause systemic symptoms such as fatigue, unintended weight loss, and weakness .

Causes

Melanoma develops when changes occur in the DNA of melanocytes. These changes in DNA turn once normal and healthy skin cells into cancer cells that grow out of control.

Ultraviolet (UV) radiation from natural or man-made sources, including tanning beds and sunlamps, is one of the main causes of melanoma, as ultraviolet rays can directly damage the DNA of skin cells .

Besides UV exposure, other risk factors that increase your risk of developing melanoma include :

  • Fair skin, naturally red or blonde hair and / or blue or green eyes.
  • Family or personal history of melanoma.
  • The presence of a large number of moles (more than 50).
  • Advanced age
  • Be a man
  • Many freckles or freckles appear easily
  • History of sunburn
  • Illness or taking medicines that weaken your immune system .

Keep in mind that people with dark skin can develop melanoma, and the similarity in skin color and birthmark makes these cases more difficult to diagnose. A little exposure to the sun or the use of sunscreen can lead to melanoma.

ABCDE rule of melanoma

Diagnostics

The diagnosis of skin cancer usually begins with a medical history and a skin exam by a dermatologist. Your healthcare provider will know your risk factors for skin cancer, such as a history of sunburn and a family history of melanoma.

When evaluating a possible melanoma, they will also consider other possible conditions. For example, acral lentiginous disease can sometimes mimic benign (benign) conditions such as warts, ingrown toenails, calluses, or athlete's foot.

Skin examination

During a skin exam, your doctor will carefully examine your skin for suspicious marks or blemishes, noting their size, shape, color, and texture. You can use an instrument called a dermatoscope, which is an instrument that contains light and a magnifying glass to better see the spots on the skin.

ABCDE rule

To help separate normal moles from melanoma, dermatologists often use a mnemonic, the ABCDE melanoma rule , during skin exams. Patients can also use this as a guide on when to see a dermatologist as soon as possible.

The ABCDE rule highlights the characteristics by which it rates a suspicious mole:

  • Asymmetry: In the case of skin cancer, the spots will not look the same on both sides.
  • Edge: A A mole or stain with fuzzy and / or ragged edges will be considered dangerous.
  • Color: Melanomas tend to be "more colorful" than common moles. The different colors or shades of the same mole are also worrisome.
  • Diameter: Melanomas are usually larger than normal moles (but, of course, not always).
  • Evolution: It refers to any changes in the mole (for example, texture, elevation, size, color, etc.)

Another potential warning sign of melanoma is a mole that stands out from other moles due to its different appearance, even if it doesn't meet the ABCDE criteria above. This is called the ugly duckling sign .

Skin biopsy

If melanoma or any other type of skin cancer or pathology is suspected, a skin biopsy will be performed. With a skin biopsy, a dermatologist removes a sample of the suspicious "spot," which can then be examined under a microscope for cancer cells by a healthcare professional called a dermatopathologist.

Sometimes, to confirm a melanoma diagnosis or to further evaluate a genetic sample of melanoma cells (which can affect melanoma treatment and prognosis), a dermatopathologist performs additional tests on a biopsy sample in a laboratory.

Visual tests

If the biopsy results show melanoma, imaging tests such as a chest x-ray or computed tomography (CT) scan may be done to find out if the disease has spread and how far it has spread .

Watch out

There are currently five treatments for melanoma : surgery, immunotherapy, targeted therapy, chemotherapy, or radiation therapy. Treatment depends largely on how deep the melamon has grown, whether the cancer has spread to other parts of the body, and your general condition. health .

Operation

All melanomas (except those known to have metastasized) will be surgically removed along with most of the normal skin. The procedure may also include a biopsy of the nearest lymph node to assess whether the melanoma has spread.

Advanced melanoma

If the disease is in a later stage, immunotherapy , which are drugs that stimulate a person's immune system to attack the cancer, or targeted therapy , which are drugs that attack melanoma cells that contain certain mutations, may be recommended. genetic

Chemotherapy, which are drugs that kill fast-growing cells, such as cancer cells, are generally considered a second-line treatment for melanoma. Radiation therapy is an unusual treatment for melanoma that is only used in isolated cases .

Prophylaxis

While you can't control all risk factors for melanoma (such as fair skin or a family history), you can protect yourself from exposure to the sun's ultraviolet (UV) rays.

Strategies to reduce total UV radiation include :

  • Avoid the sun at noon (especially from 10:00 to 14:00)
  • Wear protective clothing to cover your skin
  • Apply sunscreen
  • Looking for shade to reduce sun exposure
  • Wear sunglasses and a hat or use an umbrella outside in the sun
  • Avoid tanning beds and sunlight.

Skin self-examination

In addition to minimizing UV exposure, regular skin self-exams are important to detect new or abnormal growths before they develop into melanoma or another type of skin cancer .

When performing a skin self-exam, you should examine all parts of the body, including the elbows, armpits, buttocks, back, neck, scalp, palms, soles of the feet, and the spaces between the toes. of the feet and under them. . your nails. The mirror helps you see hard-to-reach places.

Look for any changes in the color, shape, or size of freckles, moles, blemishes, or areas that are red, itchy, or bleed. If you find something that bothers you, make an appointment with a dermatologist .

There is no set rule about how often skin self-exams should be done. Therefore, it is best to talk to your doctor about the time period that is right for you.

Get the word of drug information

The main takeaway here is that if you find a new or changing mole, patch, or patch on your skin, don't ignore it. See a dermatologist as soon as possible. Skin cancer can be cured if caught early, but it can be life-threatening if allowed to grow.

Finally, as with all cancers, prevention is key. This includes reducing exposure to direct sunlight and other forms of ultraviolet radiation, and maximizing the use of sunscreen and protective clothing.

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