melanoma

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NURUL WAHIDA BT HAMDAN 030.08.301





Malignant melanoma is the leading cause of death due to skin disease. There were 62,190 new cases of melanoma in the United States in 2006, with 7,910 deaths. One in four cases of melanoma occurs before the age of 40. Overall survival for melanomas in whites has risen from 60% in 1960-1963 to more than 85% currently, primarily due to earlier detection of lesions. Incidence of these carcinomas is greater in men than in women, and incidence increases steadily with age. Malignant melanoma is the most serious skin cancer. An estimated 10,500 people die of skin cancer each year; 7,700 of these deaths are form malignant melanoma.

Cancerous nevus (mole)




Melanoma is a serious form of skin cancer. Beginning in the melanocytes, melanoma is the most common cause of skin-related death. These melanocytes make melanin, the substance that pigments skin.

Normal, healthy skin

Superficial spreading melamona

• develops between ages 40 and 50 and is the most common type.

Nodular melanoma

• develops between ages 40 and 50, invades the dermis and metastasizes early.

Acral lentiginous melanoma
Lentigo maligna melanoma

• most common among Hispanics, Asians, and blacks; occurs on the palms of the hands, soles of the feet and under the tongue.
• most benign, rare and slow growing. Occurs between ages 60 and 70 due to a lentigo maligna on an exposed skin surface







Melanoma is caused by intense and prolonged exposure to sunlight. Sunburns cause minor skin damage, but over time and many burns, the skin can become so damaged that cells begin to divide uncontrollably: cancer. Ultraviolet solar radiation causes most skin cancers by inducing mutations in the p53 tumor-suppressor gene. Protection from the sun during the first 10-20 years of life significantly reduces the risk of skin cancer. Approximately half of melanoma cases happen only in those over 50 years of age. However, the other half includes younger people from about 20 to 30 years of age.



The first melanoma symptoms often are:
A change in an existing mole The development of a new, unusual-looking growth on your skin



Melanoma doesn't always begin as a mole. It can also occur on otherwise normalappearing skin.

„A‟

• Asymmetry, benign lesions are usually symmetrical
• Border irregularity, most nevi have clear- cut borders • Color variegation, benign lesions usually have uniform light or dark pigment • Diameter greater than 6 mm (the size of a pencil eraser)

„B‟

„C‟

„D‟

„E‟

• for Evaluation can be added.



The history of a changing mole (evaluation) is the single most important historical reason for close evaluation and possible referral. Bleeding and ulceration are ominous signs. A mole that stands out from the patient‟s other moles deserves special scrutiny, “ugly duckling sign”. A patient with a large number of moles is statistically at increased risk for melanoma and deserves careful and periodic examination, particularly if the lesions are typical. Referral of suspicious pigmented lesions is always appropriate.

Excessive exposure to ultraviolet radiation from suns ray‟s
Specific changes in the genes of skin cells that make melanin Xeroderma pigmentosum (a type of skin disease that cause melanoma)

Weakened immune system

Family history of melanoma

Large number of moles or more than one abnormal mole (dysplastic mole)

Repeated sunburns

Risk factors

Personal history of other types of skin cancer

Excessive sun exposure Red or blond hair and blue or green eyes

Exposure to UV radiation in tanning beds

Diagnostic
• Skin biopsy to confirm the diagnosis and involve removing a small area of a growth, or the entire growth (sentinel lymph node biopsy)

Treatment
• Chemotherapy  used to treat melanoma that has returned or spread. • Medications such as interferon or interleukin,  boost the immune system to fight the cancer, called immunotherapy. • Radiation treatments used to relieve pain or discomfort • Surgery

• Chest x-ray assists in staging
• Hematology



Written accounts of Melanoma‟s history are extremely sparse. While it is believed Melanoma developed in arid environments such as Australia and Africa where exposure to sunlight is immense, no one is entirely certain of the time and place the disease first originated.

Melanoma is a highly aggressive malignancy; tumors only a few millimeters in thickness can give rise to metastasis and ultimately the death of the patient. In most cases, melanoma progresses from an intraepithelial (in situ) to invasive (dermal) form. Characteristics of the dermal tumor such as thickness and mitotic activity correlate strongly with overall survival. Lesions of the extremities have the best prognosis; head and neck lesions and trunk lesions have the poorest prognosis. Only 20% to 40% of patients with regional lymph node involvement are alive and cured at 5 years.

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