Melanoma

Melanoma is a serious form of skin cancer that begins in melanocytes, the cells that produce pigment. It is less common than basal or squamous cell carcinoma, but it has a greater ability to invade surrounding tissue and spread to other parts of the body.

Melanoma is highly treatable when found early. Evaluating new, changing or unusual spots promptly can make treatment less extensive and improve the likelihood of a successful outcome.

What does melanoma look like?

Melanoma may begin in an existing mole or develop as a new spot. It can be brown or black, but some melanomas appear pink, red, white, blue or similar to the surrounding skin.

The ABCDE warning signs can help identify a suspicious growth:

• A — Asymmetry: One half does not match the other.
• B — Border: The edges are irregular, blurred, scalloped or poorly defined.
• C — Color: The spot contains multiple colors or develops an uneven distribution of color.
• D — Diameter: The growth is enlarging, although melanoma can be smaller than a pencil eraser.
• E — Evolving: The spot changes in size, shape, color, elevation or symptoms.

The “ugly duckling” sign is also important. A mole that looks noticeably different from the rest of your moles deserves evaluation.

Other warning signs include itching, tenderness, crusting, bleeding or a sore that does not heal.

Where can melanoma develop?

Melanoma can occur anywhere, including areas that receive little sunlight.

It may develop on the:

• Back, chest, arms or legs
• Face, scalp or neck
• Palms or soles
• Beneath a fingernail or toenail
• Genital area
• Inside the mouth
• Eye

Melanoma beneath a nail may appear as a dark streak or pigment extending onto the surrounding skin. Not every dark nail streak is melanoma, but a new or changing streak should be evaluated.

What increases the risk of melanoma?

Risk factors may include:

• Ultraviolet exposure
• A history of blistering sunburns
• Indoor tanning
• Numerous moles
• Atypical moles
• A personal or family history of melanoma
• Fair skin or a tendency to burn
• A weakened immune system
• Certain inherited genetic changes

Melanoma can develop in people of every age and skin tone.

How is melanoma diagnosed?

A suspicious spot is evaluated with a skin examination and dermoscopy. A biopsy is required to determine whether melanoma cells are present.

When melanoma is confirmed, the pathology report describes features such as tumor thickness and ulceration. These findings help determine the stage and guide treatment.

Depending on the melanoma’s depth and other characteristics, additional testing or a sentinel lymph-node biopsy may be discussed.

How is melanoma treated?

Early melanoma is generally treated with surgical removal of the cancer and a margin of surrounding skin.

More advanced melanoma may require:

• Lymph-node evaluation or surgery
• Immunotherapy
• Targeted therapy
• Radiation therapy
• Additional cancer-directed treatment

Treatment is personalized according to the stage, tumor features, overall health and testing results.

Schedule a melanoma evaluation

Do not wait for a suspicious mole to become painful. The Dermatology Clinic can examine new or changing spots, perform a biopsy and coordinate appropriate treatment and follow-up care. Contact us today to get scheduled.