melanoma
MELANOMA
Melanoma is a skin neoplasm that originates from malignant transformation of melanocytes.
It commonly occurs in the extremities of women and on trunk or head and neck in men.
Metastases are via lymphatic and hematogenous routes.

Introduction

  • Melanoma is a form of skin cancer that arises from melanocytic cells which make the pigment melanin that colors the skin
    • May also occur in mucosal surfaces or other sites where neural crest cells migrate eg oral, genital & rectal mucosa, eyes & nail beds
  • Predominantly occurs in adults, commonly on extremities in women & on trunk or head & neck in men
  • Metastases are via lymphatic & hematogenous routes
    • Common sites of metastases are under the skin, liver, lungs, brain & bone
    • In-transit metastases are skin or subcutaneous intralymphatic tumors that develop between the primary tumor & draining lymph nodes (LN)
  • Malignant melanoma may regress spontaneously but complete regression  is <1%

Risk Factors

  • Risk factors include:
    • Sun exposure
    • Fair skin & freckling: Less commonly, dark-skinned individuals may have melanoma & the nail beds, palms, & soles are frequently affected
    • Family & personal history of melanoma
    • Suppressed immune system
    • Environmental exposures [ultraviolet A (UVA) or psoralen plus UVA (PUVA) therapies]
    • Increased numbers of nevi & pigmentation, eg familial atypical mole-melanoma syndrome, giant congenital nevi, dysplastic nevus syndrome
  • Malignant transformation in a nevus includes changes in size & shape including border changes, discoloration, changes in consistency, presence of inflammation, & satellites
    • Deep invasion of the skin by the melanoma is shown by an increase in size, ulceration, darkening, or bleeding
Editor's Recommendations
Most Read Articles
4 days ago
In patients with atrial fibrillation (AF) and stable coronary artery disease (CAD), rivaroxaban monotherapy is noninferior to combination treatment with an antiplatelet therapy in terms of cutting the risk of cardiovascular events and mortality, according to data from the AFIRE trial.
Elvira Manzano, 6 days ago
Supplementation with omega-3 fatty acids or vitamin D3 for up to 5 years has no effect on kidney function in adults with type 2 diabetes (T2D), the VITAL-DKD* ancillary study has shown.
Jairia Dela Cruz, 3 days ago
Many patients with nonvalvular atrial fibrillation (NVAF) in Thailand use anticoagulants, but the uptake of nonvitamin-K oral anticoagulants remains suboptimal despite showing an upward trend, according to data from the COOL-AF registry presented at the European Society of Cardioloy (ESC) Asia Congress 2019 with APSC and AFC.
Yesterday
Monotherapy with tocilizumab (TCZ) shows good tolerability profile and results in remission in most patients with polymyalgia rheumatica (PMR) despite the absence of glucocorticoids, according to the 2-year results of a single-centre, open‐label pilot study.