Malignant melanoma arises from the irregular, uncontrolled growth of abnormal cells which may invade other healthy cells in the body. It can appear anywhere on the skin, and even in areas with less sun exposure. In men, it is commonly found on the back and in women, on the legs.

While melanoma is less common and slower growing than non-melanoma forms of skin cancer, it is more dangerous. If untreated, it may grow deeply into the dermis, then migrate into the blood and lymphatic systems threatening the life of the patient. With early detection and appropriate treatment protocols, melanoma can be arrested and cured.

The causes of melanoma are not completely understood, but it is clear that excessive, unprotected exposure to UV rays, from both natural and artificial sources, can promote the development of melanoma. A family history of melanoma may indicate a higher genetic risk for a patient. A patient's history of blistering sunburns early in life is also a key indicator of melanoma risk. People with many moles have a greater risk profile for developing melanoma; both the number of moles (greater than 50) and their size and shape contribute to determining the risk level. Nearly 85% of melanomas begin anew, while 15% arise from pre-existing skin moles.

Similarly, fair-skinned people have a higher risk for melanoma, as do people who burn easily or tan poorly.

Malignant melanoma is the leading cause of cancer death among women in their 20s, and the second leading cause, behind breast cancer, among women in their 30s. Recently, dermatologists report unexplained, rapid increases in melanoma among young teens.


What Should You Look For?
Malignant melanoma cells may commonly appear as brown, black or tan spots on the skin's surface, though it is possible that melanoma may be red, white, blue or skin-colored. Often lesions have multiple colors with an irregular appearance. Melanoma lesions can be flat or raised from the skin's surface.

Melanoma sends a variety of warning signals, including: a scaly texture, oozing or bleeding of a bump on the skin. Tenderness, pain or itchiness may also indicate a problematic area on the skin. In addition, pigment from a mole may spread across its borders into the surrounding skin, forming an irregular scalloped edge.

Regular self-examination of your skin's surface will aid your recognition of any significant changes in its appearance and in the development of new moles or irregular growths.

The following ABCDE Guide to Melanoma is also helpful in your evaluation.

A: Asymmetry
Melanoma lesions are usually asymmetrical. If divided by an imaginary line on the skin, then the two sides are not mirror images of each other.

B: Border
Melanoma lesions usually have irregular borders that may be blurred or poorly defined.

C: Color
Melanoma lesions vary in color, and one lesion may display a variety of colors. Colors range from light tan, to brown, black and even red, white or blue.

D: Diameter
Melanoma lesions are usually greater than 6mm (1/4 inch) in diameter (the size of a pencil eraser).

E: Evolving
Melanoma lesions are usually changing in size, shape and color and do not look like other moles on the skin. 
While a helpful first step in preventative care, self-examination is never a replacement for relying on the trained eye and expertise of your dermatologist. It may be difficult for you to perform a thorough examination or to see all the areas of your body. Regular clinical examinations by your doctor will help to document changes in your skin's condition that may signal that additional investigation is necessary.

When Should You See a Doctor?
Early detection is the key to successful outcomes in treating melanoma. When identified and treated expeditiously, melanoma can be cured. Growing, changing or new lesions should be examined by your dermatologist as early as possible. Left untreated, melanoma may be life-threatening.

A biopsy can most accurately diagnose melanoma. When melanoma is suspected, dermatologic surgery is used to remove the lesion along with the margins, the normal-looking skin surrounding it. Further examination by a pathologist will help determine the thickness and growth pattern of the melanoma. For melanoma that is identified early, this surgical approach can be virtually curative.

When melanoma has specific characteristics and thickness, it is possible that it has grown and spread, called metastasis. It is important to assess where and how deeply it has invaded other parts of the body. Some melanomas grow vertically down into the dermis, and these tumors are more likely to reach the local lymph nodes or the blood stream. Using a sentinel lymph node biopsy, it is possible to trace the melanoma's migration from the site of the original lesion to the lymphatic system, identifying the first lymph node to receive the malignancy. A surgical procedure is used to remove the particular lymph node to evaluate the presence of melanoma cells. If melanoma cells are not found in these nodes, then it is unlikely that the malignancy has moved beyond the site of the original lesion.

At Karlene Dermatology, we understand the complexity of treating melanoma cases and know that there are many pathways to successful outcomes. Utilizing the depth of our clinical experience, our goal is to detect malignant melanoma as early as possible, and once detected, formulate the best plan of care, taking into account the whole patient. Our method is multi-disciplinary as we consult with surgeons, pathologists and oncologists to devise the most intelligent, and reassuring, treatment plan for every patient. Prescribed treatments may include: surgery, chemotherapy, radiation therapy or immunotherapy.

To learn more or to schedule an office visit call 586.573.4980 (Warren) or 810.230.0001 (Flint). 



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