Melanoma Flashcards
How is melanoma identified
ABCDE - If any lesion has any of these features, it should be referred urgently under the 2-week wait pathway for suspected malignant melanoma:
Asymmetry
Border irregularity (melanoma often has a ‘scalloped’ border)
Colour variation (a variegated lesion is one that consists of many colours)
Diameter >6mm
Evolves over time
What are the four types of melanoma
Superficial spreading Nodular Lentigo maligna Acral lentiginous
What is the most common form
Superficial spreading
Where does superficial effect and what it looks like
Arms, legs, back and chest, young people - growing moles with diagnostic features
What is nodular
Red or black lump or lump which bleeds or oozes - most lethal
What does nodular effect
Sun exposed skin, middle-aged people
What is lentigo maligna
A growing mole with diagnostic features caused by sun exposed skin
Where does sacral lentigious effect
Nails, palms or soles, People with darker skin pigmentation
How doe sacral lentigious look
Subungual pigmentation (Hutchinson’s sign) or on palms or feet
What is Hutchinson’s sign
Hutchinson’s sign is a herpes zoster vesicle present on the tip or side of the nose. It reflects zoster involvement of the 1st branch of the trigeminal nerve, and is concerning for herpes zoster ophthalmicus.
What are the major diagnostic features
Change in size
Change in shape
Change in colour
What are the secondary features
Diameter >= 7mm
Inflammation
Oozing or bleeding
Altered sensation
How should suspicious lesions be treated
undergo excision biopsy. The lesion should be removed in completely as incision biopsy can make subsequent histopathological assessment difficult.
What should be done after excision diagnosis is confirmed
Once the diagnosis is confirmed the pathology report should be reviewed to determine whether further re-excision of margins is required
margins for Lesions 0-1mm thick
1cm
