Malignant Melanoma

Incidence: around 1 in 100,000.

Risk factors: UV light exposure and type 1/2 skin at most risk.

Pathology: highly malignant tumours derived from melanocytes. Can be superficial spreading (grow slow and metastasise late) or nodular.

Signs and Symptoms: although the skin is the most commonly affected organ, MM can present on the nail bed, anorectal junction and choroid. Skin lesions maybe irregulalry shaped/couloured, itchy, bleeding ulcertaed or rapidly growing. As well as examining the lesion, one should look for lymphadenopathy.

Diagnosis: physical exam and excision biopsy.  Tumours are staged either using Breslow or Clark’s classification.

Management: Margins are generally 1cm for impalpable lesions and 2-3cm for thicker lesions (>1.5mm). Some advocate dissection of regional lymph nodes if they are enlarged. Local and systemic chemotherapy may also be used.

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