Skin cancer facts: Malignant Melanoma

Skin cancer ---> Melanoma skin cancer

Skin Cancers are the most commonly diagnosed malignant tumors in the United States, with an incidence of approximately 1.4 million new cases annually. Basal cell and squamous cell skin carcinoma account for 96% of new non melanoma skin cancers. Malignant Melanoma accounts for 4% of skin cancers.

Risk factors for development of skin melanoma include ultraviolet light (UVL) exposure, fair complexion/inability to tan, blue or green eyes, blonde or red hair, freckling, history of actinic keratosis or non melanoma skin cancer, history of blistering or peeling sunburns, immunosuppression, personal or family history of melanoma, CDKN2A/p16/MC1R mutation, xeroderma pigmentosa, atypical (dysplastic) nevus, more than 100 normal nevi, and giant congenital melanocytic nevus.

The ABCD rule is used to assess skin lesions for melanoma risk: A is for asymmetry; B is border irregularity; C is color, and D is diameter greater than 6 mm.

Melanoma prognosis is inverse correlated to tumor thickness; ulceration and increased mitotic rate are independent survival risk factors; nodal tumor burden (uninvoled versus microscopic versus macroscopic disease) has an inverse correlation with survival.

Treatment: For melanoma in situ, excision margins of 0.5 to 1 cm are indicated; for invasive melanoma, wide excision of the primary tumor with margins generally ranging from 1 to 2 cm is indicated for local control.

Clinically involved lymph nodes should be resected; patients with primary melanomas of 1 mm thickness or greater and clinically negative nodes should be considered for sentinal lymph node biopsy.