Malignant Melanoma Flashcards
what are the components of the ABCDE assessment?
Asymmetry
Border irregularity (‘scalloped border’)
Colour variation
Diameter >6mm
Evolves over time
‘ugly duckling sign’ = any lesion that stands out from the rest
what are the different types of melanoma?
- superficial
- nodular
- lentigo maligna
- acral lentiginous
what is a superficial melanoma?
- commonest type of melanoma
- grows horizontally
- later grows vertically
- related to intermittent high UV exposure
- commonly found on the lower limbs of young and middle aged adults
what is a nodular melanoma?
- grows rapidly in the vertical plane
- most aggressive form of melanoma
- most common in young and middle aged adults
- commonly found on the trunk
what is a lentigo maligna melanoma?
- arises from a lentigo maligna, which is a form of melanoma-in-situ
- commonly found in the elderly population
- related to long term cumulative UV exposure
- most common on the face
what is an acral lentiginous melanoma?
- occurs on the palms/soles and under the nails
- no clear association with UV exposure has been identified
what is the appropriate next step when a suspicious pigmented lesion is identified?
urgent 2-week referral to a dermatologist
what is breslow thickness?
- depth of the tumour
- strong predictor of the outcome
- used to predict recurrance
what should be performed if the breslow thickness is >1mm?
sentinel node biopsy
look for evidence of metastases and stage the cancer
what wider excision margin should be used when removing melanoma?
- stage 1 = 0.5cm
- stage 2 = 1cm
- stage 3 = 2m
what is the management of stage III or IV malignant melanoma?
wide excision biopsy + chemo or immunotherapy
what is the breslow thickness of a low risk of recurrance melanoma?
<0.75mm
what is the breslow thickness of a medium risk of recurrance melanoma?
0.75-1.5mm
what is the breslow thickness of a high risk of recurrance melanoma?
> 1.5mm
