Melanoma

Melanoma can develop anywhere on your body. They may develop in an existing mole in 20 – 30 % of individuals or in otherwise normal skin. In men, melanoma most often appears on the face or the trunk. In women, this type of cancer most often develops on the lower legs. In both men and women, melanoma can occur on skin that hasn’t been exposed to the sun.

Melanoma can affect people of any skin tone. In people with darker skin tones, melanoma tends to occur on the palms or soles, or under the fingernails or toenails.

Melanoma signs include:

  • A large brownish or black spot with darker speckles
  • A mole that changes in color, size or feel or that bleeds
  • A small lesion with an irregular border and portions that appear red, white, blue or blue-black
  • Dark lesions on your palms, soles, fingertips or toes, or on mucous membranes lining your mouth, nose, vagina or anus

Melanoma can metastasize to other organs and can lead to death.

The following are warning signs of having a melanoma:

Melanoma Risk factors

There are four types of melanoma.  Three of them begin in situ.  This means they start in the top layer of skin. They then can become more invasive with time.  The fourth is invasive from the start. Invasive melanomas are more serious.  They penetrate deeper into the skin and may can spread to other areas of the body.

Superficial spreading melanoma: This is the most common type.  They account for 70 percent of melanomas. This is most often seen in young people. As the name suggests, this melanoma grows along the top layer of the skin for some time before penetrating more deeply.

The first sign is the appearance of a flat or slightly raised discolored patch that has irregular borders and is somewhat asymmetrical in form. The color varies, and you may see areas of tan, brown, black, red, blue or white. This type of melanoma can occur in a previously benign mole or arise as a new lesion. It can be found almost anywhere on the body but is most likely to occur on the trunk in men, the legs in women, and the upper back in both.

Lentigo maligna:   This melanoma is similar to the superficial spreading type. It too remains close to the skin surface for a while, and usually appears as a flat or mildly elevated, mottled, tan, brown or dark brown discoloration. This type of in situ melanoma is found most often in the elderly.  It arises on chronically sun-exposed, damaged skin on the face, ears, arms and upper trunk. Lentigo maligna is the most common form of melanoma in Hawaii. When this cancer becomes invasive, it is referred to as lentigo maligna melanoma.

Acral lentiginous melanoma: This melanoma also spreads superficially before penetrating more deeply. It is quite different from the others, though, as it usually appears as a black or brown discoloration under the nails or on the soles of the feet or palms of the hands. This type of melanoma is sometimes found on dark-skinned people and tends to advance more often than superficial spreading melanoma and lentigo maligna because it is detected later. It is the most common melanoma in African-Americans and Asians.  It is the least common melanoma in Caucasians.

Nodular melanoma:  This melanoma is usually invasive at the time it is first diagnosed. The malignancy is recognized when it becomes a bump. It is usually black, but occasionally is blue, gray, white, brown, tan, red or skin tone.

The most frequent locations are the scalp, trunk, legs and arms.  It is found mainly in elderly people. This is the most aggressive and deadly of the four types of melanoma.

There is a variant of melanoma which has no pigment and can be whitish in color.  It is known as an amelanotic melanoma.  Since they do not have pigment, they can go unnoticed.  There can be a delay in diagnosis and thus a poorer prognosis.

If melanoma is recognized and treated early, it is almost always curable. If it is not, the cancer can advance and spread to other parts of the body, where it becomes hard to treat and can be fatal. While it is not the most common of the skin cancers, it causes the most deaths. Approximately 180,000 melanomas are diagnosed each year. Melanoma kills an estimated 9,320 people in the U.S. annually.

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