Melanoma

Question 1

ABCDE criteria for examining a mole

Answer 1

Asymmetry

Border irregularity

Colour variation

Diameter >6mm

Elevation - raised indicates invasion

Question 2

what are the two growth phases of a melanoma

Answer 2

radial - no metastatic potential

vertical - metastatic potential

Question 3

what is breslow thickness a measure of?

Answer 3

measure of vertical growth

• prognosis of patient
• greater the breslow thickness, the worse the prognosis

Question 4

where is breslow thickness measured from?

Answer 4

granular layer to deepest invading cell in mm

Question 5

types of melanoma from most common to least

Answer 5

1. superficial spreading
2. nodular melanoma
3. lentigo maligna
4. acral lentiginous

Question 6

features of superficial spreading melanoma

Answer 6

changing mole displaying ABCDE features

younger people

sun exposed sites - arms/legs/back/chest

Question 7

appearance of nodular melanoma

Answer 7

red/black lump that may bleed/ooze

Question 8

what is important to remember about nodular melanoma

Answer 8

dont have radial growth phase

• poorer prognosis as in vertical growth phase from day 1
• high metastatic potential

Question 9

features of lentigo maligna

Answer 9

changing mole on chronically sun exposed skin- commonly face

elderly patients

prolonged radial growth phase

Question 10

appearance of acral melanoma

Answer 10

rapidly growing pigmented lesion on palms/soles/nails

• late presentation, poor prognosis

Question 11

what is hutchisons sign

Answer 11

subungal pigmentation in acral melanoma

Question 12

management of a suspicious mole

Answer 12

excision biopsy with 2mm margin

Question 13

survival if breslow thickness

<1mm

>4mm

Answer 13

<1mm = 95-100%

>4mm = 50%