Melanoma Recognition: What It Is, What It Is Not

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Melanoma can be hidden at a glance, surrounded by moles, freckles, bruises, and other skin defects that distract from cancerous threats.

ABCDE

Fortunately, tracing the trajectory of some common melanoma features can establish the path to a correct diagnosis.Originally developed for patients, the American Academy of Dermatology ABCDE rule The recognition of melanoma is also easily applied to the initial laboratory examination of suspicious lesions.

• A-Asymmetry: Half of the melanoma does not match the other half

• B-Boundary irregularity: Irregular edges, notches or blurry appearance

• C-Color: Non-uniform color, various shades of brown or tan, red, white, or blue spots

• D-Diameter: Usually, but not always, larger than 6 mm (about ¼ inch) in diameter.

• E-Evolution: Visually different from other moles and skin lesions.Looks like the size, shape, or color is changing

Other features that can guide the diagnosis towards or away from melanoma include the anatomical location of the lesion, personal and medical history, skin type, and lifestyle factors. All factors should be taken into account in a comprehensive assessment of a patient’s skin condition and suspicious lesions.

Types of skin lesions: benign and other

Knowing what is not melanoma plays an important role in recognizing what melanoma is.

General mole

Mole (or nevus) is essentially a cluster of pigment cells (melanocytes). Mole generally has a uniform appearance. Most moles The nevus (or nevus, plural) is brown, round, flat, or slightly raised and does not change in size or appearance from month to month. Usually they are not bigger than a pencil eraser and are often smaller.

Aside from generality, it is important to continue to be aware of fluctuations and outliers. Mole colors come in a variety of colors, including tan, black, red, pink, blue, and skin tones. It may be colorless. Some moles have hair. The size and appearance may not change from month to month, but some moles change slowly over time and may even disappear.

Mole can occur anywhere on the body Will be displayed in most cases Above the waist in areas exposed to sunlight. Most adults have 10-40 moles, and people can continue to develop moles until about 40 years old. In the elderly, moles can decline. Most people with dark skin or hair have dark moles.

In rare cases, common moles can develop into melanoma. Signs that need to be seen with some suspicion are changes in size, color, shape, texture, height, or dry, scaly, itchy, bleeding or bleeding moles. It is included. People with a lot of moles (50 or more, especially 100 or more) are at increased risk of developing melanoma.

Atypical mole or dysplastic nevus

As the name implies, atypical moles differ from common shapes in one or more important properties such as size (large), color, and shape.

Although different in appearance, atypical moles are usually stable for long periods of time and do not cause melanoma.The only exception is the person who has 5 or more dysplastic nevus.. The risk of melanoma is higher than in people without dysplastic nevus. When the number of dysplastic nevus exceeds 5, the likelihood of melanoma is high.

Congenital mole

Some people are born with one or more moles known as congenital moles. They vary in size from small to very large and have a range of possible colors. Congenital moles increase the likelihood of melanoma, especially for people with multiple congenital moles.

Lesions can appear anywhere on the body, but most commonly on the trunk and limbs.

Spitz nevus

Spitz nevus is a benign skin growth, but the presence of lesions is associated with an increased risk of developing melanoma. Growth shares many characteristics with melanoma and was once considered a type of skin cancer.

The appearance of the classic Spitz nevus is pink, raised and dome-shaped, but the lesions may be a mixture of colors such as red, black, and brown.

Spitz nevus most often occurs on the face, neck, or legs, but it can also occur on the arms, shoulders, or trunk.

Spitz nevus may bleed and, in some cases, may have oozing openings. Growth usually manifests itself in the first 20 years of life. They tend to grow fairly rapidly before they stabilize. As we grow older, the Spitz nevus may regress.

Actinic keratosis

They are Cancer precursor lesion It tends to occur on areas of the skin that are most damaged by exposure to sunlight, such as the face, ears, scalp baldness, hands, neck, and lips. Actinic keratosis (AK) of the lips is also known as actinic cheilitis. Due to the precancerous condition, all AKs should be evaluated by a dermatologist or skin cancer specialist.

AK is most common in people over the age of 40. It’s not uncommon, but AK has a subtle look at first. For example, a patch of rough skin with a pink tint or a scaly skin. In contrast to benign moles and nevus, AK can be painful when rubbed or scratched.

In some cases, AK appears as a brown patch and can be mistaken for normal skin aging. However, the patch can be grainy or scaly. Actinic cheilitis can resemble a whitish, dry area of ​​the lips and can easily crack. If ignored, AK can develop into skin horn-like growth. This is associated with an increased risk of skin cancer and should be assessed immediately by a skin specialist.

Seborrheic keratosis

Benign growth with aging, Seborrheic keratosis It appears as a brown, black, or tan growth with a slightly raised, waxy or scaly texture. The most common areas are the face, neck, chest and back. They vary in size from small diameters to over 1 inch. Itching is a fairly common feature.

If the lesion becomes inflamed or bleeding, the patient may consider surgically removing seborrheic keratosis.

Examination of skin lesions according to the situation

The majority of skin lesions are not melanoma. However, the aggressive and potentially deadly nature of melanoma makes recognition, vigilance, and early recognition essential. To counter the risk of overdiagnosis and overtreatment, keep in mind the salient features of melanoma and consider them in the light of patient-specific factors and family history.

The risk of melanoma is increased in patients who:

• Have fair skin, red or blonde hair, blue eyes, and especially a combination

• Has a history of chronic and intense exposure to sunlight, including the use of tanning salons and personal tanning equipment

• More likely to get a sunburn than a sunburn

• Have a history of sunburn at an early age, especially multiple episodes of sunburn

• Have a personal or family history of skin cancer

• Have more than 50 moles, typical or atypical

Skin biopsy: the definitive answer

If all signs indicate melanoma, or if the level of clinical suspicion is high, a biopsy remains essential to a definitive diagnosis. If diagnostic uncertainty persists, it is a wise intermediate step to consult a dermatologist or skin cancer specialist.

Involves the patient in the decision, regardless of the clinical pathway of choice or preference. Discuss the clinical impressions of skin tests thoroughly, including potential harms and benefits, and options for continuing. Make sure that decisions are shared to increase the chances of patient satisfaction.

Read Part 1 of this series. Melanoma: Epidemiology, diagnosis, and treatment