Skin Disease: Malignant Melanoma

Melanoma, also known as malignant melanoma, is the deadliest form of skin cancer. According to the World Health Organization it is estimated that 132,000 people are diagnosed with the disease annually, and it is the cause of death for more than 37,000 people annually (Hodgetts, 2013). The cancerous growths begin to develop when DNA in skin cells is damaged, normally by excess exposure to ultraviolet radiation either from sunlight or tanning beds. This damage triggers mutations. This causes the skin cells to multiply rapidly and form malignant tumors. The tumors originate from pigment producing cells, also called melanocytes. These cells are located in the basal layer of the epidermis. Melanocytes are responsible for producing melanin, a protective

The number one sign of melanoma is a new or changing mole/blemish. The ABCDE system should be used when evaluating skin lesions (Hodgetts, 2013). First check for asymmetry, both halves of the mole should have the same shape. Next the border is assessed; normal moles usually have a smooth regular border while melanoma tends to have a more irregular or ragged edge. The color of a mole should be uniform throughout, if not this is also a warning sign. Changes in color are also unwanted. Diameter is also an important characteristic to look at. Most melanomas are greater than 6mm, although they can be smaller. The final letter E stands for evolution. Melanomas change over time while normal moles do not (Hodgetts, 2013). Melanoma may also be accompanied by symptoms such as newly onset itching, tenderness, bleeding, or ulceration (Hodgetts,

Other types of biopsy methods may be used such as wedge or punch biopsy, but these techniques tend to be less accurate. After the biopsy is performed a wide excision should follow. This should encompass a l good margin of healthy tissue. Any further excision will depend on the thickness of the tumor. Depending on the invasive ness of the tumor a lymph node biopsy might be conducted to see if any of the draining lymph nodes were affected (Hodgetts, 2013). If this comes back positive a radical lymph node dissection will be necessary, this may be followed by radiation, depending on the number of nodes affected (Hodgetts, 2013). In the treatment of stage IV tumors there are many methods used. Tumors and lymph nodes may be surgically removed. Patients may also be treated with radiation, immunotherapy, chemotherapy or targeted therapy. At this stage the disease is very hard to cure due to metastasis. Recently the plan of treatment for stage IV tumors has changed. Newer forms of targeted drugs and immunotherapy have proven to be more effective than chemotherapy. Immunotherapy drugs such as ipilimumab, pembrolizumab, and nivolumab have been shown to help some people suffering from advanced forms of melanoma live longer, although, some of these drugs have severe side