A
melanoma is an aggressive form of skin cancer, which originates in
the melanocytes or pigment cells and can be fatal when it spreads to
other parts of the body. In the last decade
the number of patients with malignant
melanoma in Europe has increased enormously. The good news is that
most melanoma can be cured, when they are removed in an early stage
and most can even be prevented when we check our moles regularly.
Your dermatologist can nowadays make a more accurate diagnosis with
advanced
dermatoscopy. In most European
countries dermatologist organize screening days for melanoma during
the months may and june
How
does a melanoma develop?
Moles
are brown or black coloured
spots or elevations of the skin, which are formed by pigment
cells. They can be congenital, but arise especially in childhood and
puberty. A new mole that develops after puberty should always be
monitored. Approximately 40% of melanomas develop in an existing
mole. The color is mostly brown or black, but they can also have
pink, red, blue or white tints.
Do
I have an increased risk for Melanoma?
●
Somebody
in the family with melanoma
●
A
personal history of melanoma
●
A
high number of moles
●
Irregular
moles
●
Light
skin type and /or blue or green eyes
●
Sunburns
in childhood and after
●
outdoor
activities
What
should I pay attention to?
It’s
Important
that you get to know your own body. Melanomas can develop over the
entire skin fig 1 and 2 so you have to look from the crown of your
head to the soles of your feet, including mouth, nose and genitalia.
To
asses whether a mole is suspect, we usually the American ABCD rule
(Figure 3). The A (Asymmetry) for irregular shape, the B (Border) for
irregular edge, the C(Colour)
for an irregular or very dark colour
and the D (Diameter) for a diameter larger than 5mm. Finally, the E
(Evolution) is added. Moles that change shape, color or size are in
principle suspect as well as new moles.
Dermatoscopic
examination by the dermatologist
Although
a good self-examination is useful first step, it is sometimes very
difficult to distinguish a melanoma form a mole or other pigmentation
spots. Your dermatologist can make a more accurate diagnosis with a
dermatoscope fig 4 ,a kind of microscopic instrument. When in doubt,
a tissue examination is always necessary.
How
are melanomas and suspicious moles treated?
Suspected
moles or melanomas are always removed surgically. Subsequently, it is
send to the pathologist for histologic examination, which confirms
both the diagnosis and if the melanoma is completely removed. Usually
In case of a melanoma a re excision is performed to create a safety
margin in combination with further examinations to exclude
metastases.Remember that a mole is principally an innocent and often
asymptomatic spot, but a melanoma can be fatal. In any doubt check it
out and show it to your dermatologist.
Ruud
Valks, dermatologist,
member
of the American Academy of Dermtology
Figure 1 Melanoma on the occipital
area of the head
Figure 2 Melanoma on the sole of the
right foot
Figure 3. ABCD Rule
Figure 4. Dermatoscopy
