NIH – Melanoma (Medical Encyclopedia) Melanoma is the most dangerous type of skin cancer. It is the leading cause of death from skin disease. It involves cells called melanocytes, which produce a skin pigment called melanin. Melanin is responsible for skin and hair color. Melanoma can also involve the colored part of the eye. For information about that form of melanoma, see melanoma of the eye. … There are 4 major types of melanoma: • Superficial spreading melanoma is the most common type of melanoma. It is usually flat and irregular in shape and color, with varying shades of black and brown. It may occur at any age or body site, and is most common in Caucasians. • Nodular melanoma usually starts as a raised area that is dark blackish-blue or bluish-red, although some are without color. • Lentigo maligna melanoma usually occurs in the elderly. It is most common in sun-damaged skin on the face, neck, and arms. The abnormal skin areas are usually large, flat, and tan with intermixed areas of brown. • Acral lentiginous melanoma is the least common form of melanoma. It usually occurs on the palms, soles, or under the nails and is more common in African Americans. Melanoma can spread very rapidly. Although it is less common than other types of skin cancer, the rate of melanoma is steadily increasing. It is the leading cause of death from skin disease. Risk factors include the following: • Family history of melanoma • Red or blond hair and fair skin • Presence of multiple birthmarks • Development of precancerous lesions • Obvious freckling on the upper back • Three or more blistering sunburns before age 20 • Three or more years spent at an outdoor summer job as a teenager • High levels of exposure to strong sunlight … Prevention: Protect yourself from the sunlight's damaging ultraviolet rays. This includes the following: • Applying a sunscreen with SPF 15 or higher, every day (during winter months as well) • Wearing protective clothing, including hats and sunglasses • Refraining from intentionally lying in the sun or using tanning devices • Minimizing sun exposure o Especially during the summer o Particularly between the hours of 10:00 a.m. and 2:00 p.m. “

NIH - Melanoma “Melanoma is the most serious type of skin cancer. Often the first sign of melanoma is a change in the size, shape, color or feel of a mole. … Thinking of "ABCD" can help you remember what to watch for: • Asymmetry - the shape of one half does not match the other • Border - the edges are ragged, blurred or irregular • Color - the color in uneven and may include shades of black, brown and tan • Diameter - there is a change in size, usually an increase “

NIH – NCI What You Need To Know About™ Melanoma “Signs and Symptoms Often, the first sign of melanoma is a change in the size, shape, color, or feel of an existing mole. Most melanomas have a black or blue-black area. Melanoma also may appear as a new mole. It may be black, abnormal, or “ugly looking.” If you have a question or concern about something on your skin, see your doctor. Do not use the following pictures to try to diagnose it yourself. Pictures are useful examples, but they cannot take the place of a doctor’s examination. Thinking of “ABCD” can help you remember what to watch for: … (view photos) …Melanomas in an early stage may be found when an existing mole changes slightly, for example, when a new black area forms. Newly formed fine scales and itching in a mole also are common symptoms of early melanoma. In more advanced melanoma, the texture of the mole may change. For example, it may become hard or lumpy. Melanomas may feel different from regular moles. More advanced tumors may itch, ooze, or bleed. But melanomas usually do not cause pain. A skin examination is often part of a routine checkup by a health care provider. People also can check their own skin for new growths or other changes. (The “How To Do a Skin Self-Exam” section has a simple guide on how to do this skin self-exam.) Changes in the skin, such as a change in a mole, should be reported to the health care provider right away. The person may be referred to a dermatologist, a doctor who specializes in diseases of the skin. Melanoma can be cured if it is diagnosed and treated when the tumor is thin and has not deeply invaded the skin. However, if a melanoma is not removed at its early stages, cancer cells may grow downward from the skin surface and invade healthy tissue. When a melanoma becomes thick and deep, the disease often spreads to other parts of the body and is difficult to control. People who have had melanoma have a high risk of developing a new melanoma. People at risk for any reason should check their skin regularly and have regular skin exams by a health care provider.”

NHS - Skin cancer expert Barry Powell on the questions to ask (Video)

NHS - Skin cancer (malignant melanoma) “Malignant melanoma is the most serious type of skin cancer because it affects a deeper layer of skin than the other types, so the risk of the cancer spreading is much higher. Melanomas can appear anywhere on your body, but the back, legs, arms, and face are the most common sites. The first sign of a melanoma is either the appearance of a new mole, or a change in the appearance of an existing mole. Normal moles are usually a single colour, round, or oval in shape, and are not larger than 6mm (1/4 inch) in diameter. In contrast, melanomas have an irregular shape, they are more than just one colour, and they are often larger than 6mm (1/4 inch) in diameter. In some cases, the melanoma may also be itchy and occasionally bleed. … Risk factors: Risk factors for developing skin cancer include: • having pale skin that does not tan easily, • having red, or blonde, hair, • having blue eyes, • having a large number of moles, • having a large number of freckles, and • having a condition that suppresses your immune system, such as HIV, or taking medicines that suppress the immune system (immunosuppressants). All these risk factors will make your skin more sensitive to the effects of the sun. Other causes: In some rare cases, skin cancer can also be developed from exposure to certain substances including: • coal tar, • soot, • pitch, • asphalt, • creosotes, • paraffin waxes, • petroleum derivatives, • hair dyes, • cutting oils, and • arsenic. You should ensure you wear adequate protective clothing if your profession involves prolonged exposure to any of these substances.”

Highlighted Articles

Progression of malignant melanoma is associated with reduced 25-hydroxyvitamin D serum levels. (Exp Dermatol. 2008) “In conclusion, our findings add to the growing body of evidence that 25-hydroxyvitamin D serum levels may be of importance for pathogenesis and progression of malignant melanoma.”

Partner Assistance Improves Skin Self-Examination for Detecting Melanoma "Teaching people skin self-examination (SSE) with their partner rather than alone significantly improves the likelihood that the person will perform SSE and find problematic lesions, according to the results of a randomized controlled trial reported in the January issue of Archives of Dermatology. The article reviews ABCDE (asymmetry of shape, border irregularity, color variegation, diameter = 6 mm or higher, and evolution of the lesion) rules for examining moles and notes that 50% of melanomas are discovered by patients themselves."

Comparison of risk patterns in carcinoma and melanoma of the skin in men: a multi-centre case-case-control study. (Br J Cancer. 2006) "Subjects with fair hair had a significant risk increase for all types of tumours ... The effect of pale eyes was significant … Intermittent sun exposure measured in hours spent at beach during holidays was significant … and number of naevi."

Highlighted Internet Sites

NCI - Melanoma

NCI – What You Need To Know About Melanoma