SKIN CONDITIONS

About Melanoma

Types of skin cancer

There are three different types of skin cancer - basil cell carcinoma, squamous cell carcinoma, and malignant melanoma.

Basal cell carcinomas are the most common type in fair-skinned persons and seldom appear in African-Americans. The tumor usually appears as a small fleshy bump on the head, neck, or hands, but may develop in other areas as well. These tumors grow slowly and only very rarely do they spread to other parts of the body.

Squamous cell carcinoma is the second most common skin cancer in fair-skinned people. It usually appears as a bump or a red, scaly patch on the face, ear, lips, or mouth. It can develop into large masses, and can spread to other parts of the body. If found and treated early, both basal cell and squamous cell carcinomas have a cure rate of about 95%.

Melanoma is a type of skin cancer that occurs in the cells that color the skin (melanocytes). It is a more serious type of cancer than the common basal cell or squamous cell skin cancers, because it can spread to other parts of the body through the lymphatic system or the blood. Melanoma is the leading cause of all skin cancer-related deaths.

What causes melanoma?

Although no one knows exactly what causes melanoma, one of the main risk factors appears to be exposure to ultraviolet (UV) radiation from too much sun or even from tanning booths. However, people who are exposed to intense sun over a short period of time (weekend tanners) are more at risk for melanoma than people, such as farmers or sailors, who have a more consistent daily sun exposure.

While melanoma can occur in people who are darkly pigmented, people with fair skin who tend to sunburn or freckle easily, especially those with red or blond hair, are at greater risk. Painful, blistering sunburns, especially in childhood or adolescence, can put people at risk. Melanoma also can run in families, especially those with a history of dysplastic nevus syndrome - a tendency to have many abnormally sized or shaped moles all over the body.

How is melanoma diagnosed?

Often, a diagnosis of melanoma results from a routine checkup or from a patient bringing a suspicious mole to a doctor's attention. The first sign of melanoma is usually a change in the size, shape, or color of a mole. Another symptom of melanoma is a change in how a mole feels; it can become tender, itchy, or hard. Melanoma can also appear on the body as a new mole. Take a look at the following chart to see what kinds of things to look for and to show your doctor.

ABCD's of melanoma	benign	melanoma
Asymmetry Melanoma (malignant) lesions may be irregular in shape (asymmetrical); benign (nonmalignant) moles are typically round (symmetrical).
Border Melanoma lesions may have irregular borders (ragged or notched edges); benign moles usually have smooth, even borders.
Color Melanoma lesions may contained many shades of brown, blue, or black; benign moles are usually a single shade of brown.
Diameter Melanoma lesions are often more than 6 millimeters in diameter (about the size of an eraser on a pencil); benign moles are usually less than 6 millimeters in diameter.

Your doctor may wish to perform a biopsy on a suspicious mole. A biopsy is the removal of some or all of a mole or other growth for diagnosis by microscopic examination. With a suspicious mole, an excisional biopsy is most often performed. In this procedure, the physician removes an elliptical wedge of skin that fully surrounds the mole. this wedge extends completely through the skin, so that the depth of the suspected melanoma can be accurately measured. The biopsy wound is closed with stitches and the sample is sent to the laboratory
for analysis.

Stages of Melanoma

Stage IA

The tumor is 1.0 millimeter (mm) or less in thickness without ulceration and Clark level ll/lll. The tumor has not spread to the lymph nodes or distant organs.

Stage IB

The tumor is 1.0 mm or less in thickness with ulceration or clark level lV or V, or between 1.01-2.0 mm without ulceration. It has not spread to the lymph nodes or distant organs.

Stage IIA

The tumor is 1.01-2.0 mm with ulceration or
between 2.01-4.0 mm without ulceration. It has not spread.

Stage IIB

The tumor is between 2.01-4.0 mm with ulceration or greater than 4.0 mm without ulceration. It has not spread.

Stage IIC

The tumor is greater than 4.0 mm with ulceration. It has not spread.