Melanoma of the skin
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nodular melanoma

superficial spreading melanoma

partly nodular melanoma

Malignant melanoma - a short introduction.

What is melanoma?

Malignant melanoma is a serious type of skin cancer. Proliferation of benign melanocytes results in benign melanocytic naevi (moles) and lentigines (freckles). Malignant melanoma is due to uncontrolled, cancerous growth of transformed melanocytes.

Who is at risk?
Although melanoma can occur in all races, white skinned individuals are most at risk. It is believed that excessive sun exposure is a major risk factor for development of melanoma. The incidence of malignant melanoma is highest among fair skinned individuals living in sunny climates (Australia, southern United States etc). Other risk factors include: sun exposure and sunburn  during childhood, family history of melanoma and the presence of large numbers of moles or abnormal moles on the skin .

Types of melanoma

When the melanoma cells are confined to the epidermis only, the lesion is called melanoma in situ. When the melanoma cells are found below the basement membrane it is known as invasive melanoma. These invasive melanomas can have a horizontal growth phase (superficial spreading melanoma) or a vertical growth phase (nodular melanoma). Rarer types of melanoma include: desmoplastic melanoma, mucosal melanoma, acral lentiginous melanoma, amelanotic melanoma and melanoma of the eye.

Metastatic disease

Invasive melanoma may spread to other tissues via the lymphatic system or via the blood stream. Organs such as the brain and the lungs may be affected. The chance of metastasis mainly depends on the penetration of melanoma cells into the skin at the site of the primary melanoma lesion. Thus, early detection and -removal of melanomas is of vital importance!

Early detection of melanoma
Most melanomas present as a changing freckle or mole. A change in shape or colour (or both) may be detected. In many cases dark pigment appears that may be black, grey or blue. However, hypopigmented, skin coloured or red elements may also occur in a melanoma. Growth of moles may also be a sign of malignant transformation as are signs such as pain, itch or bleeding. Doctors use checklists when examining moles in order to determine the melanoma risk of individual moles. It should be noted that not all melanomas show these characteristics or they present only with a few of the characteristics mentioned below. On the other hand, not all moles that show changes prove to be malignant.

Glasgow 7-point checklist
Major features:
change in size
irregular shape
irregular colour
Minor features:
diameter > 7mm
change in sensation
A: asymmetry
B: border irregularity
C: colour variation
D: diameter > 6 mm
E: evolving (changing,

Pigmented lesions that show changes should always be checked by an experienced doctor!

Treatment of melanoma

Melanoma (or moles suspected to be melanoma) are removed surgically. Thick melanomas require more extensive surgery than thin melanomas. Most countries have national guidelines regarding melanoma treatment procedures. For treatment details please consult your national guidelines (United Kingdom, Australia/NZ, USA).

very large nodular melanoma

superficial spreading malignant melanoma

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