Melanoma

WHAT IS MELANOMA?

Melanoma is a malignant tumour that may develop on a pre-existing nevus in 30 % of the cases or it may arise de novo on normal appearing skin. The most common sites are the trunk in men, and the legs and trunk in women. Melanoma presents generally as a macule (photo 29)or nodule(photo 31) with variegated colours and ill-defined borders( photos 28,30).

When diagnosis is made in an early phase (photo 36), the cure is possible and is provided by surgical excision. In contrast, a late diagnosis (photos 43, 44) may allow dissemination to internal organs and it is associated with a poor prognosis. Thus, prevention is the only, concrete and effective tool we have to face melanoma.

What does melanoma look like? – the A-B-C-D-E rule

The risk of developing cancer is often handed down as our genes also play a significant role in skin cancer. Anyone who knows of cases of the disease in their own family and has one of the higher-risk skin types should take the precaution of going for an annual check-up. A melanoma is often not recognisable to the naked eye and at first looks hardly any different from a mole or a birthmark.
The A-B-C-D-E rule can be useful in making an early diagnosis. If a mole is asymmetric (A) (photo 37), has no distinct borders (B)(photo 32), if its colour changes (C)(photos 33,34), it is larger than  6 mm inch in diameter (D)(photo 40).

Evolution (E), (also Elevation) such as changes in color, shape, size, elevation, skin surface (photos 35, 38,39, 41,42), and symptoms such as itching or bleeding of a lesion are a hallmark sign of malignancy. Furthermore the appearance of any new lesion on previously normal looking skin in a patient over 40 years old is considered suspicious and should prompt him/her to consult a dermatologist.

EXAMINATION OF A LESION SUSPICIOUS FOR MELANOMA

The whole body surface area is examined for any suspicious lesions. In case there are no such lesions the dermatologist will reassure you and explain to you what exactly are the different lesions/ spots you have on your skin.
The dermatologist will not only examine  suspicious lesions with the naked eye but he can use also a dermatoscope which is a hand held device that is placed on the skin and magnifies the lesion checked thus enabling a more accurate and early diagnosis of melanoma( photos 45, 46).
Some people may present with different forms of skin cancer (photo 47) or might develop a new skin cancer at a later time so it is important that a person checks himself his skin regularly and also arranges follow up visits with his dermatologist.

Persons with multiple nevi on the body or with multiple atypical nevi are at greater risk ( photo 48) and might benefit from a follow up with digital photography.