Index Introduction to malignant melanoma: Melanoma in situ: Distinct factors between benign and malignant nevi: Superficial spreading melanoma: Nodular melanoma: Lentigo maligna melanoma: Acral lentiginous melanoma: Conclusion: References: Introduction to Malignant Melanoma: Melanoma is the most dangerous type of skin cancer, this cancer develops from melanocytes, which are the cells that produce melanin and are found in the basal layer. One of the most common causes of skin cancer is exposure to UV rays from the sun. Overexposure causes DNA damage, when DNA is damaged and allowed to multiply mutations occur which cause skin cells to rapidly replicate forming a tumor. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essay Melanomas usually resemble moles and as such it is very easy to confuse them with one another, although they have some key differences that help identify whether it is a melanoma or not. This is crucial since in its early stages it is almost always treatable, making it that much more important that professionals know how to identify it. If diagnosed early it can save a person's life. There are 4 main types of malignant melanomas, these are nodular melanoma, lentigo maligna melanoma, acral lentiginous melanoma and superficial spreading melanoma. Melanomas don't always look the same, which makes it important for professionals to know all the different ways they can appear. Melanoma in situ: If melanoma is diagnosed early, there is a chance that it is still in situ. This is the earliest stage and means that the cancer cells have not yet spread throughout the body and are still confined to the area where they began to develop. This is the most important time to make a correct diagnosis since the cancer cells are still localized. If part of the skin is suspected to have a malignant growth (due to presenting some symptoms of a melanoma), the entire affected area will be removed by a process called excision, and if the area is too large a biopsy will be performed with engraving. The sample is then examined under a microscope and a pathology report will be drawn up which will help plan the next step if it turns out to be malignant. Distinguishing Factors Between Benign and Malignant Moles: Moles are very common and are usually benign, but in some cases, they may evolve or change. There are a couple of warning signs for melanoma that differentiate it from benign moles. The warning signs are known as ABCDE rules. These are Asymmetry, Edge Irregularity, Color Variation, Large Diameter and Evolution. Normal moles are usually symmetrical while malignant moles usually have an asymmetrical shape. A benign nevus usually has a defined, smooth, even border. In the case of melanoma, the edges tend to be irregular and serrated. Benign moles usually have the same color all around, usually a shade of brown, malignant moles can have multiple shades of brown and black. It can also become a shade of red or white. The diameter of moles is also smaller than that of melanoma, its diameter can be up to 6 mm, although they may have been smaller when initially detected. Over time, melanomas begin to evolve and change. It is important that if the person notices any changes, they are reported immediately as these do not occur in normal benign moles. Superficial spreading melanoma: This is the most common type of skin cancer and makes up about 70% of all cases. This melanoma grows on the top layer of theskin until it eventually penetrates deeper into the skin although this usually takes months. It usually appears as a flat or slightly raised patch of skin with irregular edges and an asymmetric shape. It can appear in a variety of colors including red, blue, black and brown. Figure 2 shows how different the same type of melanoma can look. This type of melanoma has the potential to develop from a previously benign nevus, although it can develop as a new lesion and not necessarily on a nevus. This type of melanoma initially has a horizontal growth stage, meaning it initially looks like a flat area of ​​discolored skin that slowly enlarges. Very often it is mistaken for a mole, a lentigo or freckles. When a patient is suspected of having superficial spreading melanoma (SSM), the doctor may diagnose the melanoma using a skin biopsy or dermoscopy. If the suspected melanoma is 0.8 mm thick, a blood test and lymph node biopsy are recommended. The pathology report will have the following if melanoma is present. There should be proliferation rate, Breslow thickness and Clark level of invasion showing the anatomical plane of invasion (the deeper the Clark level the greater the risk). The report may also contain the cell type, growth pattern, and whether the disease is in situ or associated with an original nevus. (These steps are always necessary to confirm the presence of cancer cells.) People with darker skin are less likely to get melanoma, it is as common in men as it is in women and only 15% of people get melanoma before age 40 and only 1% of people get it before age Age 20 Other things that can put a person at risk are having many moles, having easily burned skin, and having a prior melanoma. Nodular melanoma: Nodular melanoma grows vertically rather than horizontally like SSM. It can arise from normal-looking skin or from an existing melanoma, it can develop from a superficially spreading melanoma if the malignant cells pass through the epidermis into the dermis. Within a few months it can penetrate deep into the skin. People with nodular melanoma (NM) tend to have light skin and tend to tan easily, as opposed to people with darker skin who are less likely to get it. Although there is a stronger correlation with sun exposure, SSM and Lentigo than with nodular melanoma. An increased age, any previous cases of melanoma, and the presence of many moles or birthmarks. Melanoma can develop anywhere, although it is more likely to appear in exposed areas of the skin. Nodular melanoma sometimes does not follow the ABCD rules in its early stages as it is typically symmetrical in shape, has regular borders, uniform colors, and has a relatively small diameter (less than 6 mm). For this reason it is necessary to use the EFG rule. .The EFG summarizes the clinical characteristics of NM, i.e. elevation, firmness to palpation and constant growth over a month. It is important that during the anamnesis the patient can provide all the information on the lesion in question. In this case the lesion may bleed or change in elevation, so these questions should be asked to the patient to see if he has observed such changes. Under normal circumstances, the NM will follow the ABCD rule and will be asymmetrical, have irregular edges, a large diameter (larger than a mole) and may have different colors such as black, brown or red. The melanomas seen in figure 3 all follow the rule. Lentigo maligna melanoma: Lentigo maligna melanoma (LMM) is an invasive skin cancer that develops from lentigo maligna. Lentigo maligna is confined to the epidermis andthen it remains on the other surface of the skin. It is only when lentigo maligna invades the dermis layer that LMM is diagnosed. The probability of this happening is very low, around 5%. The number increases if the lesion is larger than 4 cm, in which case the probability rises to 50%. Usually, people who work outdoors in the sun, people with fair skin, and the elderly are more likely to get lentigo maligna. Males are also more likely to get the disease, but this could be due to sun exposure from work. Areas of the body normally exposed to the sun, particularly the face and nose, are more likely to be affected. Lentigo maligna grows slowly while LMM spreads very quickly and aggressively. Lentigo Maligna and LLM also share a very similar appearance but it is important that the practitioner can distinguish them. Figures 4 and 5 show how easy it is to confuse one with the other. You can use the ABCDE rule but they both share the same characteristics as they are both asymmetrical, have irregular edges, have abnormal color variations (dark brown-red or pink), have a large range and evolve. There are only a few characteristics that they do not share, namely that the lesion may start to bleed and itch, it may start to thicken, and it may show abnormal colors such as blue or black. Figure 4: This is the presentation of LLM://www.dermnetnz.org/topics/lentigo-maligna-and-lentigo-maligna-melanoma/ In a study conducted by lentigo, similar melanomas have a high probability of being identified by the patients themselves, even dermatologists have recognized this type of lesions as malignant, especially when they have their typical appearance. Patients with this type of melanoma usually have severe dermatoheliosis (up to 30%) and also have a history of sunburn (up to 90%). This data could help professionals establish a correlation with the patient's medical history and the lesion presented to them. Acral lentiginous melanoma: Acral lentiginous melanoma (ALM) is the only type of melanoma mentioned that has no correlation with sun exposure, as the areas where ALM appears are not generally exposed to the sun. In a study conducted by Al-Hassani, F., Chang, C., Peach, H., they came to the conclusion that this type of melanoma is linked to microtraumas, more precisely to traumas in the areas subjected to load, since it is there that the highest concentration of ALM was found (83.5% was found in the weight-bearing areas of the foot). ALM typically affects the palms of the hands and soles of the feet, but is more common on the feet. In its early stages, it looks like a flat patch of discolored skin that slowly expands. Initially it remains in the epidermis, which is the tissue of origin of ALM, but as the months pass it begins to expand and eventually becomes invasive (this is when the dermis is penetrated). ALM is relatively rare compared to other melanomas, there is no correlation between skin color and the speed of onset. Since skin color does not affect ALM, there is a higher chance of a person with darker skin getting this type of melanoma as they are less likely to get the other types. The ALM is recognized by the ABCDE rule because it is asymmetric, has irregular edges, has an anomalous color, has a large diameter and evolves. Figure 6 shows these features. Please note: this is just an example. Get a custom paper from our expert writers now. Get a Custom Essay Conclusion: As discussed above, melanoma can come in different forms and they all have different characteristics. It is important that professionals are able to identify and1-2