Melanoma Flashcards
Melanoma epidemiology
Fastest increasing
15-50 y/o
increased sun exposure
Etiology and risk factors of melanoma
Cumulate and prolonged UV exposure
Genetic CDKN2A mutation
Uncontrolled prolif of melanocytes
Fair skin, atypical nevi, greater thn 25 nevi, tanning beds
Melanoma CMs
Asymptomatic
Sun exposed or non exposed areas
Pigmented papular, plaque or nodule
ABCDEs
New growth, bleeding, itching
ABCDEs
Asymmetry - shape and color
Border - irregular or notched
Color - very dark
Diameter - over 6mmm (larger than pencil eraser) and changing
Evolving - evolution or change in any ABCDs
Superficial spreading melanoma CMs
Most common
Irregular color, surface, notched border
Horizontal growth phase initially
Will grow 2.5 cm before invading
Men - back
Women - back and legs
Nodular melanoma CM
Rapid growht
More aggressive
Blue-black, smooth or eroded nodule
Anywhere on the body
Vertical growth phase initially so less llikely to diagnose at premalignant stage
Lengtigo maligna
Sun exposed areas
Horizontal initally for years
Multicolor, elevated in areas
Slow
Acral letinginous CF
Occurs on palms, soles, distal on toes or fingers
Most common on great toe or thumb
Black and enlagergin
More common in darker skin
Vertical grwoth early on
Concerning of acral lentiginous
Dystrophy of the nail
Involvement of proximal
6mm stripe width
Asymmetric
Amelanotic
Appearance
Dx
Variakble morphological appearance
Appearance of pigment is subtle
May be confuse with other dzs
Biopsy to ID
the evolution*** is important here
Melanoma dx and tx
Skin bipsy
Survival depends on early dx
Surgical excision often curative
Margin of normal skin excied based on depth of melanoma
LN mapping and biopsy if more than 1mm thick…prognositc info…determine if adjuvant therapy needed
Key prognostic factors
Thickness or depth is first
Ulceration or high mitotic rate is worse
Involvement of LN or distant metastases is worse
