Malignant melanoma

Question 1

Malignant melanoma risk factors

Answer 1

• Caucasian ethnicity
• female sex
• over 35 years of age
• family history of melanoma
• many moles
• previous naevi

Question 2

Types of malignant melanoma

Answer 2

• superficial spreading melanoma - irregular margin and surface, varied pigmentation
• lentigo - sun-damaged areas, e.g. face, neck, scalp
• acral lentiginous melanoma - occurs on peripheries, e.g. palms and soles, not related to UV exposure

Question 3

Melanoma presentation

Answer 3

• asymmetry
• borders (irregular)
• colours (variation)
• diameter (>6mm)
• evolving or enlarging

Question 4

Melanoma prognosis

Answer 4

• Breslow thickness
• depth of invasion to deepest point of tumour invasion

Question 5

Melanoma management

Answer 5

• manage with wide local excision:
• thickness ≤1 mm: margin 1 cm
• thickness 1-2 mm: margin 1-2 cm
• thickness >2-4 mm: margin 2 cm
• thickness >4 mm: margin 2 cm
• Mohs micrographic surgery
• topical imiquimod
• sentinel lymph node biopsy