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Melanoma

Melanomas are malignant tumors that originate in the melanocytes of the epidermis (skin cells that produce melanin, a substance responsible for giving skin its color).

It is one of the most malignant tumors of the skin and mucous membranes.

It is characterized by not having local aggressiveness but by an early tendency to metastasize through lymphatic tissue and blood that cause death.

Its incidence is increasing worldwide. It mainly affects adults of any age, with a mean age of 53 years. In young adults, it is the cancer with the highest annual incidence rate.

It is more common in women than in men in the ratio of 2: 1.

The individual most at risk of melanoma is the subject with fair skin, which tends to burn
rather than tan, with blond or red hair and freckles.

Causes of melanoma

The cause of melanoma is not known.

Sunlight, being ultraviolet B light, the most important component in its production. The incidence in targets is inversely proportional to latitude, that is, it is greater near the Equator and decreases progressively towards the poles.

The incidence is higher in whites than in blacks, especially in those who burn more easily than they tan. Those who suffer sunburn during childhood or adolescence have a higher incidence of melanomas.

Melanoma is more dependent on intermittent sun exposure, especially early in life, than on a cumulative effect of exposures.

The increase in holiday exposures would have contributed to the increase in incidence, together with the depletion of the ozone layer and the subsequent increase in the amount of ultraviolet light reaching the Earth.

Why and how is it produced?

It is a malignant tumor originating in the melanocytes of the epidermis. It is spread in different ways:

  • Through the lymphatic tissue, either in the skin near the injury, in transit to the drainage node, or in said node. It is the most frequent route.
  • Through the blood it can reach any organ, mainly the lung. The involvement of the nervous system center is the leading cause of death.
  • Through the placenta.

Melanoma symptoms

Pigmented lesion characterized by:

  • Asymmetry.
  • Irregularity of its edges.
  • Irregular coloring, with different shades of gray, red, etc.
  • Diameter greater than 6 mm. – Elevated areas.
  • Most asymptomatic, sometimes it can cause itching or pain.

There are four clinical subtypes:

Melanoma over lentigo maligna.

It is characterized by:

  • It is located in areas exposed to the sun such as the face.
  • More frequent in women, with an average of 65 years.
  • It grows in two phases, initially radial for 5 to 20 years and later vertically in weeks or months.
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Superficial growing melanoma.

It is characterized by:

  • It is located in areas exposed to the sun and covered. In women especially in the legs and in men in the upper back area.
  • More common in women with a mean age of 44 years.
  • Initially flat and later its surface becomes irregular with infiltration areas of a papular, nodular or verruciform appearance.

Nodular melanoma.

It is characterized by:

  • More aggressive clinical course.
  • Rapidly growing hyperpigmented nodule, very dark of uniform color. The surface is eroded frequently.

Acral lentiginous melanoma.

It is characterized by:

  • More frequent in black and oriental subjects.
  • It is located on the palms, soles, fingers, mucous membranes and under the nails, being the most frequent finding on the soles, especially on the heel.

How is it diagnosed?

When a pigmented lesion is suspected to be melanoma, an excisional biopsy should be performed that includes the entire lesion, in order to be able to carry out a correct pathological study.

If the lesion is of a size that its simple excision is not possible and it will cause a disfigurement, an incisional biopsy will be performed that includes the highest area of ​​the same.

Melanoma treatment

Two indices are used to measure the degree of vertical invasion:

  • Clark index: measures the anatomical levels of invasion.
  • Breslow index: measures the depth in millimeters, from the granulosa to the deepest tumor cell.
The most important thing is the diagnosis and early surgical removal.

Tumors with a Breslow smaller than 1 mm are excised with a margin of 1 cm; if it is greater than 1mm, the margin must be 2 cm. There is no agreement on preventive removal of lymphadenopathy.

Other possible treatments are: chemotherapy, radiotherapy , immunotherapy, etc.

Avoid melanoma

The incidence of melanoma is increasing in recent years. Early detection and treatment is of vital importance for the patient, since thinner melanomas have a higher survival rate.

Although the relationship between melanoma and exposure to ultraviolet rays has not yet been perfectly established, in many countries campaigns are being introduced advising a reduction in sun exposure, especially for those with greater risks due to having a large number of nevi, presenting nevi dysplastic or having a family history of melanoma. All these patients must be periodically monitored by an expert.

In patients who have already had one melanoma, the risk of developing a second melanoma is 10%. It is advisable to do a revision 1 or 2 times a year, selectively excising those lesions that are more atypical clinically or that have changed in a different way than the other pigmented lesions have done.

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Hello Readers, I am Nikki Bella a Psychology student. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. My collaboration as an editor in the psychology area of ​​Well Being Pole has allowed me to investigate further and expand my knowledge in the field of mental health; I have also acquired great knowledge about physical health and well-being, two fundamental bases that are directly related and are part of all mental health.

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