What is the Melanoma
Melanoma is one of the most malignant skin cancers. Melanoma is a malignant tumor of melanocytes, which tends to early lymphatic and hematogenous metastasis. The incidence is increasing in many countries of the world, and most often occurs in people with pale skin who are often exposed to the sun. Melanoma occurs in unchanged skin or in precursor lesions. The greatest malignant potential has a large congenital and dysplastic nevi. Melanoma is usually dark in color, from brown to black, but can be with and without pigment.
Passes through three stages of growth: melanoma in situ (means the stage of malignant melanocytes in the basal layer of the epidermis), the radial phase (phase means a lateral expansion), and the vertical phase (phase of the invasion of the dermis). According to clinical and histological features, it can distinguish lentigo melanoma (melanoma in situ), LLM (lentigo maligna melanoma), surface-spreading Melanoma SSM (superficial spreading melanoma), nodular melanoma (melanoma nodular NM-) akrolentiginoz melanoma (acral lentiginous melanoma ALM- ).
Malignant melanoma is the most malignant form of skin cancer. Although it makes up about 4% of all forms of malignant skin changes, it causes 80% of all deaths in that group of diseases due to its aggressiveness and ability to rapidly spread (metastasize) lymphoma and hematogenic pathways. It is estimated that this year about 54,000 people in Europe and 130,000 in the world will suffer from malignant melanoma. Every year about 37,000 people die from malignant melanoma worldwide, and the number of new cases increases from 3 to 7 percent every year.
How to recognize melanoma?
One of the basic features of melanoma, which makes this tumor a “bad reputation,” is its unpredictable behavior. Melanoma can occur as a change in a previously unhealthy youngster or may occur as a new tumor on the skin that may resemble nipple, keratosis, skin cancer, and the like. In some cases, melanoma progresses “only” locally without distant metastases, whereas in other patients, distant metastases may first be detected, and the primary tumor remains undetected.
Melanoma can occur in people of any age, but the highest frequency is between 45 and 55, as in men and women. Although the exact cause is still unknown, the main risk factors for the emergence of melanoma are enhanced exposure to the sun (especially occasionally, so-called “recreational” exposure to the sun), light tint and hair, sunburn in childhood, then a large number of adolescents especially large congenital or dysplastic, atypical youth) as well as a positive family or personal history.
Defining the main risk factors (genetic and environmental-derived) for melanoma production is essential for optimizing primary prevention strategies – avoiding risk factors, and secondary prevention – early recognition of symptoms and signs of melanoma.
Avoidance of risk factors and early recognition of melanoma are the most important factors in its successful prevention.
Genetically determined risk factors for the time can not be changed or eradicated. However, if we avoid risk factors arising from the environment, observing the instructions regarding the protection against harmful effects of UV radiation from the sun or artificial sources, we significantly reduce the risk of melanoma development.
The etiology of melanoma is unknown. Basically, genetic changes occur in the root of the pigment variations. The highest risk of melanoma skin development is that patients are more likely to be unaware of this disease. There is a high risk of having multiple sclerosis, dysentery syndrome (DNA), flatulence or light color hair, sensitized “and pajamas.” There is also familial skin melanoma, genetically conditioned, in 5% of the fever. overwhelming sun exposure, exposure to ultraviolet A and B taming, especially in childhood and youth.
Prevention of melanoma is a very important segment that should be further insisted on. A useful algorithm for estimating suspicious pigmented changes is the so-called. The ABCDE rule includes the finding of an asymmetry of change, an irregularity of the edge, the presence of more colors, a diameter greater than 6 mm, and an increase or elevation from the surface, or a change in the already existing youth during a certain period of time. Malignant alterations may also include bleeding, ulceration, scab, redness, pain, or itching. If a person or her partner notices that a certain change in the skin has increased or changed, it is necessary to report to a dermatologist who will evaluate the significance of the existing changes and suggest further testing.
Primary prevention consists of educating the population, especially the risk groups, to avoid risk factors: sunburn, ultraviolet A and B sunburn, sunburn, and quartzose the goat Secondary prevention aim to diagnose early, thin, inflammatory skin melanoma Relating to risky groups of populations should, through the form of the questionnaire, recognize make early skin melanoma in order to timely report to a specialist institution.
Dermoscopic examination of pigmental changes undoubtedly assumes all the more important place in the early detection of melanoma. It is a simple, non-invasive, fast-paced, and very useful method to help establish a more reliable diagnosis of pigment lesions, and to distinguish melanoma from other benign pigmental changes. The clinically reliable diagnosis of “naked eye” melanoma is estimated at 65%, and the dermoscopic examination significantly improves this reliability by 5-30%.
This review of pigmental changes undoubtedly assumes all the more important places in the early detection of melanoma. Also, this method allows early detection of other skin tumors. The examination itself is very easy to do, and the resulting picture can be stored in the computer, after a certain time compares with an earlier dermoscopic picture, or send to another dermatologist for additional expertise. Given the increasing incidence of skin tumors, we advise patients to report to their dermatologists at least once a year and examine their patients with a dermoscopic examination.
Melanoma is the most aggressive of all skin tumors because it rapidly metastases and involves other organs. However, one should not panic, because its early detection and timely surgical intervention allow cure and increase the survival rate.
Surgical removal of melanoma at an early stage leads to healing in 90 to 95 percent of patients. If diagnosis and treatment are delayed, the likelihood that the patient will survive is very small.
If we want to keep the melanoma mortality rate at the lowest possible level, periodic self-diagnosis of the skin and timely addressing a doctor when there is a suspicion of melanoma should become standard practice.
The most important elements of successful prevention of melanoma are the avoidance of risk factors and early recognition of the disease.
The most important measure for the prevention of skin cancer is the effective protection against UV rays:
- In any case, it should be prevented that the skin from burns in the sun.
- Between 11 and 15 hours, when the UV radiation burden is greatest, stay cool.
- When it’s sunny to wear a hat, sunglasses and appropriate clothes.
- Apply sun cream with a high protection factor.
- Baby up to one year old should never be exposed to the sun directly.
- Protecting the child from the sun in particular.
- avoid unnecessary exposure to sun rays from 11 to 17 hours
- wear protective clothing, hats, and sunglasses that are impermeable to UV radiation
- application of sunscreen
- skin self-examination
- examination of the skin of the sexual partner
- Do not go to the solarium
- Departure to the dermatologist once a year
It is recommended that you review your own skin at certain intervals and observe pigmental changes. If changes occur on the skin or on the youngster, they should contact the skin doctor for control.
Numerous studies have found that one of the important risk factors for the occurrence of melanoma is occasional, intense exposure to UV radiation, especially if it is accompanied by burns. It should be remembered that this exposure to UV rays seems to be the most important cause and in the development of adolescents, ordinary or atypical. Children should not be exposed to sun rays until their first year of life and do not need to apply sunscreens. Later, direct sunlight effects should be avoided in the period from 11 to 17 o’clock, and sunscreens with a factor greater than 30 should be applied to the skin of the body. Given the fact that in children, although very rarely, it can manifest melanoma is to regularly control the existing youth. It is necessary to do continuous education, especially for younger populations, about the harmfulness of exposure to the sun or visiting solariums.