Lecture 8 Part 1

<p>Most melanomas are over 5 mm in diameter (B)</p> Signup and view all the answers

<p>Lesions that are significantly different should be biopsied (C)</p> Signup and view all the answers

<p>Color extending beyond the nail onto surrounding skin (B)</p> Signup and view all the answers

<p>Surgically remove the entire visible lesion (B)</p> Signup and view all the answers

<p>Mutation of the CDKN2A gene (D)</p> Signup and view all the answers

<p>90% 10-year survival (B), 100% cure rate with complete excision (D)</p> Signup and view all the answers

<p>Survival rates drop significantly (C)</p> Signup and view all the answers

<p>Sentinel lymph node biopsy (SLNB) (B)</p> Signup and view all the answers

<p>Require extensive imaging studies (A)</p> Signup and view all the answers

<p>To obtain a diagnosis and determine the depth (A)</p> Signup and view all the answers

<p>2-4 mm (D)</p> Signup and view all the answers

<p>Primary excision (A)</p> Signup and view all the answers

<p>A rim of normal skin is also removed (C)</p> Signup and view all the answers

<p>1 in 75 (B)</p> Signup and view all the answers

<p>Superficial spreading melanoma (C)</p> Signup and view all the answers

<p>Individuals living near the equator (A)</p> Signup and view all the answers

<p>Nodular melanoma (A)</p> Signup and view all the answers

<p>Having a first-degree relative with melanoma (A)</p> Signup and view all the answers

<p>Palms and soles (B)</p> Signup and view all the answers

<p>Irregular pigmentation (A)</p> Signup and view all the answers

<p>Lentigo maligna melanoma (C)</p> Signup and view all the answers

<p>1 in 75 (C)</p> Signup and view all the answers

<p>It presents as a raised lesion. (A)</p> Signup and view all the answers

<p>Individuals with light pigmentation (D)</p> Signup and view all the answers

<p>Upper back (D)</p> Signup and view all the answers

<p>Having a first degree relative with melanoma (D)</p> Signup and view all the answers

<p>Pronounced irregularity (B)</p> Signup and view all the answers

<p>On the palms and soles (B)</p> Signup and view all the answers

<p>80% (C)</p> Signup and view all the answers

<p>Perform a sentinel lymph node biopsy. (B)</p> Signup and view all the answers

<p>Surface ulceration. (D)</p> Signup and view all the answers

<p>60% (A)</p> Signup and view all the answers

<p>Complete excision is the only treatment required. (D)</p> Signup and view all the answers

<p>Close follow-up visits. (A)</p> Signup and view all the answers

<p>To ensure the melanoma is completely excised. (C)</p> Signup and view all the answers

<p>Prognosis becomes extremely poor. (C)</p> Signup and view all the answers

<p>Melanomas have irregular but sharp borders. (D)</p> Signup and view all the answers

<p>Areas that are black, blue, or gray. (B)</p> Signup and view all the answers

<p>Biopsy the lesion immediately. (B)</p> Signup and view all the answers

<p>Color change. (C)</p> Signup and view all the answers

<p>Most melanomas are over 5 mm, but not always. (C)</p> Signup and view all the answers

<p>It encodes proteins involved in cell cycle regulation. (C)</p> Signup and view all the answers

<p>The rate of color and size change over time. (A)</p> Signup and view all the answers

Factors that increase the likelihood of developing melanoma include sun exposure, light skin pigmentation, many moles, family history of melanoma, and Dysplastic Nevus Syndrome.

Melanoma includes superficial spreading, nodular, acral, and lentigo maligna.

Usually flat, irregularly pigmented, and appears as a macule or thin plaque.

Usually raised, often ulcerated lesion.

Typically flat, brown to black lesion on palms and soles.

Develops on sun-damaged skin, typically on the face, and appears as a large, irregular age spot (lentigo).

A method for identifying melanoma based on asymmetry, border irregularity, color variation, diameter, and evolution.

One half of the mole is noticeably different from the other half.

A melanoma's border is often sharp but uneven, unlike the relatively regular borders of most nevi.

Melanoma often displays black, blue, or gray areas, which are particularly concerning. However, it can also present with various shades of brown.

Most melanomas exceed 5 mm in diameter. However, size alone isn't always a reliable indicator.

A key sign of melanoma: noticeable changes in color, size, or other features. Nevi rarely change significantly.

If a patient has many moles, examine them closely as one mole that looks distinctly different from others should be biopsied.

Melanoma under the fingernail or toenail. It resembles a subungual hematoma, but it does not grow out with the nail, unlike a bleed. Color extending onto the surrounding skin is a very concerning sign.

This gene, responsible for p16 and p14ARF proteins, is often mutated in melanoma. These proteins are involved in crucial cell cycle regulation pathways (Rb and p53).

When melanoma is suspected, the entire visible lesion should be surgically removed and analyzed by a pathologist to confirm the diagnosis.

The thickness of a melanoma significantly impacts the prognosis. Deeper melanomas are associated with lower survival rates. Melanoma <1mm has a 90% 10-year survival rate, while deeper melanomas (4mm+) drop to 50% survival.

Melanoma with an open sore on the surface has a significantly worse prognosis compared to non-ulcerated melanoma, regardless of depth.

Once melanoma spreads to lymph nodes or other organs, the prognosis significantly worsens.

Complete surgical excision is the only treatment needed for melanoma ≤1 mm.

Melanoma >1mm requires complete excision, close follow-up, and potentially lymph node evaluation (biopsy or sentinel lymph node biopsy).

Initial removal of a suspicious lesion to obtain a diagnosis and determine the depth of melanoma.

Second surgery to remove the entire melanoma and a margin of healthy tissue around it.

The amount of healthy tissue removed around the primary excision site depends on the stage of the melanoma.

Exposure to sunlight, especially intense or prolonged, increases the risk of developing melanoma. This is especially true for people living closer to the equator.

People with light skin, freckles, and many moles are at higher risk for melanoma, as they have less melanin to protect them from sun damage.

Having a family history of melanoma, especially with multiple family members or dysplastic nevi, significantly increases the risk for an individual.

The most common type of melanoma, it appears as a flat, irregularly pigmented lesion with an uneven border. It can vary in color and size.

The second most common type of melanoma, it presents as a raised, often ulcerated lesion. It can grow quickly and is usually darker.

This type of melanoma typically appears on the palms, soles, or under the fingernails/toenails. It's often flat and brown or black.

This melanoma develops on sun-damaged skin, usually on the face, and appears as a large, irregularly pigmented age spot.

A mole that changes in color, size, or shape is a major red flag for melanoma. This is a more worrisome sign than many other melanoma characteristics.

If you have many moles, one that looks significantly different from the others (in size, color, or shape) might be a melanoma, even if it doesn't have all the typical melanoma features.

A melanoma often has a sharp but irregular border, unlike the smooth borders of most moles. This is another important clue for identifying melanoma.

The CDKN2A gene is often mutated in melanoma. This gene encodes proteins involved in cell cycle control, which helps explain why melanoma cells grow uncontrollably.

When melanoma is suspected, the entire visible lesion is surgically removed and examined under a microscope to confirm the diagnosis.

Melanoma under the fingernail or toenail can be tricky to diagnose, as it can resemble a bruise. However, unlike a bruise, it won't grow out with the nail. Additionally, if the color spreads beyond the nail, it's extremely concerning and requires immediate biopsy.

Color is often the most reliable indicator of a melanoma. Look for black, blue, or gray areas within the mole, although various shades of brown are also possible.

The thickness of a melanoma, measured in millimeters, is a key factor determining prognosis. Deeper melanomas are associated with lower survival rates.

Melanoma confined to the top layer of skin (epidermis) with a 100% cure rate if completely removed.

A procedure to determine if melanoma has spread to nearby lymph nodes when the tumor is >1 mm deep and no palpable lymph nodes are found.

The size of the rim of normal tissue removed around the primary excision site is determined by the stage of the primary melanoma.