Melanoma

Question 1

What is melanoma?

Answer 1

Skin cancer caused by abnormal proliferation of melanocytes (pigment containing cells)
=Superficial spreading
=Nodular
=Lentigo
=Acral Lentiginous

Question 2

Risk factors for metastatic melanoma

Answer 2

-Personal or family history of skin cancer
-Pale skin that burns easily
-Light-coloured hair and eyes (blue green)
-Ultraviolent radiation (*history of sunburn)
-Large number of moles
-Increasing age (peaks at 65)
-Organ transplant recipients(immunosuppression)
-Psorelin UVA

Question 3

Why is melanoma important?

Answer 3

-Melanoma 3rd most common skin cancer in the UK
= 8100 new cases per year
=Incidence is 17 per 100,000
=Second most common cancer in adults 25-49

-Moles (pigmented skin lesions) account for many GP consultations and most are benign
=Moles are common and most people have 20–50 moles
= Malignant change is uncommon
=< 1 in 33,000 moles are estimated to become malignant

Question 4

Mechanism and pathophysiology of metastatic melanoma

Answer 4

Malignant transformation is process
-UV radiation causes mutations that cause proliferation
-Increase rate of division
-High mutational load
-Evasion mechanisms from immune system

Question 5

Prognosis of melanoma

Answer 5

All dependant on stage
Stage = tumour thickness + level of ulceration(size) and spread
Stage 1A= 95%
Stage 4= 7-19%

Question 6

Investigation of melanoma

Answer 6

-Referral to derm/plastics
-Dermoscopy + skin check

Question 7

Management of melanoma

Answer 7

-Surgery
-Immunotherapy
-Surveillance