What Does The Early Stages Of Melanoma Look Like

What Does Melanoma Look Like

Melanoma is a type of cancer that begins in melanocytes . Below are photos of melanoma that formed on the skin. Melanoma can also start in the eye, the intestines, or other areas of the body with pigmented tissues.

Often the first sign of melanoma is a change in the shape, color, size, or feel of an existing mole. However, melanoma may also appear as a new mole. People should tell their doctor if they notice any changes on the skin. The only way to diagnose melanoma is to remove tissue and check it for cancer cells.

Thinking of “ABCDE” can help you remember what to look for:

• Asymmetry: The shape of one half does not match the other half.
• Border that is irregular: The edges are often ragged, notched, or blurred in outline. The pigment may spread into the surrounding skin.
• Color that is uneven: Shades of black, brown, and tan may be present. Areas of white, gray, red, pink, or blue may also be seen.
• Diameter: There is a change in size, usually an increase. Melanomas can be tiny, but most are larger than the size of a pea .
• Evolving: The mole has changed over the past few weeks or months.

Melanomas can vary greatly in how they look. Many show all of the ABCDE features. However, some may show changes or abnormal areas in only one or two of the ABCDE features.

A Primer On Skin Cancer

Malignant melanoma, especially in the later stages, is serious and treatment is difficult. Early diagnosis and treatment can increase the survival rate. Nonmelanoma skin cancers include basal cell carcinoma and squamous cell carcinoma. Both are common and are almost always cured when found early and treated. People who’ve had skin cancer once are at risk for getting it again they should get a checkup at least once a year.

How Common Is Melanoma

Melanoma accounts for only about 1% of all skin cancers, but causes the great majority of skin cancer-related deaths. Its one of the most common cancers in young people under 30, especially in young women.

Melanoma incidence has dramatically increased over the past 30 years. Its widely accepted that increasing levels of ultraviolet exposure are one of the main reasons for this rapid rise in the number of melanoma cases.

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The 5 Stages Of Nail Melanoma

Nail melanoma is a life-threatening skin cancer that grows to affect the nails, usually the big toe and thumb. This disease can prove to be very deadly, however treatments are readily available if diagnosed early.

This disease is often referred to as, Malignant Melanoma of Nail Unit or Nail Unit Melanoma.

• The pigment producing cells of the body, called Melanocytes, is where the Melanoma cancer develops. The Melanocytes are responsible for giving our skin its color.

• The development of Melanoma cancer, usually begins from a finger or toenail, however thats not always the case.

• It has the tendency to affect the areas around such as the sides of nail or the nail bed. In fact, it may also spread to other parts of the body, if not treated on time.

• The big toe or thumb is usually the first to get affected, however it may vary according to each case.

• The Nail Unit Melanoma is divided into 3 main types:

• Nail Melanoma is most common in light/fair skinned people as opposed to dark skinned people.

There are 5 stages of Nail Melanoma, stated as follows

Stage 1: aka Stage O Melanoma

This stage is also referred to as Melanoma in situ, meaning site of origination of Melanoma. At this point, a tumor has formed on the outermost layer of the skin, epidermis.

Stage 2: aka Stage I Melanoma

This stage is further categorized into two:

Stage IA: At this stage, the tumor is less than a mm deep and has no signs of an ulcer.

Stage 3: aka Stage II Melanoma

What Does Early Skin Cancer Look Like

• When to See a Healthcare Provider

It can be challenging to tell if a skin change is unimportant or, in fact, is a sign of developing skin cancer. Skin cancer is not uncommon, as one in five Americans will develop skin cancer before age 70. Learning to spot the warning signs is vital. When identified early, skin cancer is highly curable. Do you know what to look for or when to seek medical advice?

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Differentials To Be Considered

• Peutz-Jeghers syndrome
• Physiologic pigmentation

The amalgam tattoo is a frequent finding in persons who have had amalgam restorations . When the amalgam is removed with a high-speed dental handpiece, amalgam particles can be embedded or traumatically implanted in the oral mucosa. Silver from the amalgam leeches out of the embedded particles and stains selected components of the fibrous connective tissue and highlights the blood vessels. The pigment is often solitary, macular, gray-black, and found near where amalgams were placed and subsequently removed. The gingiva, palate, lateral tongue, and buccal mucosa are commonly involved sites. If the particle is large enough, a dental radiograph may show radiopaque amalgam particles in the soft tissue or bone. Fragments of the amalgam can be observed on histologic specimens, and, on occasion, a foreign body giant cell reaction is noted.

Graphite tattoos result from pencil lead that is traumatically implanted, usually during the elementary school years. A gray-black pigmented, often macular area, commonly found in the palate, corresponds to the size of the implanted lead or the rub from its introduction. Older persons with these tattoos may not be able to recall the event.

Lead shot and bullets also leave rub tattoos in the soft tissue of people who experience such violence.

Medication-induced pigment may be more localized and blotchy. AZT is often a culprit.

What Are The Symptoms Of Skin Cancer Of The Head And Neck

Skin cancers usually present as an abnormal growth on the skin. The growth may have the appearance of a wart, crusty spot, ulcer, mole or sore. It may or may not bleed and can be painful. If you have a preexisting mole, any change in the characteristics of this spot – such as a raised or an irregular border, irregular shape, change in color, increase in size, itching or bleeding – are warning signs of melanoma. Sometimes the first sign of melanoma or squamous cell cancer is an enlarged lymph node.

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Lip Cancer Prevention And Treatment

The best prevention is to examine your lips and report any changes in the skin, such as lip color changes, sores, or growths, to your dentist or physician as soon as possible. According to the Mayo Clinic, two treatments are common with this type of cancer.

The first is to surgically remove the patch or sore and remove some surrounding tissue to ensure all cancerous cells are gone. The second form of treatment is radiation therapy. This process applies safe sources of radiation to kill the cancer cells in your mouth. Your dentist should thoroughly examine the rest of your mouth for issues with your gums and teeth and treat those first before radiation therapy.

Lip cancer can be treated and often cured if diagnosed early, so examine your lips regularly for appearance changes. Then report those changes to your dentist or physician as soon as possible. With early detection and quick treatment, lip cancer can be eliminated.

Tools That Can Help You Find Melanoma On Your Skin

To help you find melanoma early, the American Academy of Dermatology developed the following:

Melanoma can look different on a childs skin. Taking this short quiz can help you hone your skills at finding childhood melanoma.

ImagesImages 1,3,4,5,6,7,8,10: Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

Image 2: Developed by the American Academy of Dermatology

Image 9: Used with permission of the Journal of the American Academy of Dermatology.

ReferencesBarnhill RL, Mihm MC, et al. Malignant melanoma. In: Nouri K, et al. Skin Cancer. McGraw Hill Medical, China, 2008: 140-167.

Gloster HM Jr, Neal K. Skin cancer in skin of color. J Am Acad Dermatol 2006 55:741-60.

National Comprehensive Cancer Network. NCCN guidelines for patients: Melanoma. 2018. Last accessed February 12, 2019.

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Diagnosis And Staging What It Means For You

How is melanoma diagnosed?

To diagnose melanoma, a dermatologist biopsies the suspicious tissue and sends it to a lab, where a dermatopathologist determines whether cancer cells are present.

After the disease is diagnosed and the type of melanoma is identified, the next step is for your medical team to identify the stage of the disease. This may require additional tests including imaging such as PET scans, CT scans, MRIs and blood tests.

The stage of melanoma is determined by several factors, including how much the cancer has grown, whether the disease has spread and other considerations. Melanoma staging is complex, but crucial. Knowing the stage helps doctors decide how to best treat your disease and predict your chances of recovery.

Look Out For An Ugly Duckling

The Ugly Duckling is another warning sign of melanoma. This recognition strategy is based on the concept that most normal moles on your body resemble one another, while melanomas stand out like ugly ducklings in comparison. This highlights the importance of not just checking for irregularities, but also comparing any suspicious spot to surrounding moles to determine whether it looks different from its neighbors. These ugly duckling lesions or outlier lesions can be larger, smaller, lighter or darker, compared to surrounding moles. Also, isolated lesions without any surrounding moles for comparison are considered ugly ducklings.

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Squamous Cell Skin Cancers

Squamous cell skin cancers can vary in how they look. They usually occur on areas of skin exposed to the sun like the scalp or ear.

Thanks to Dr Charlotte Proby for her permission and the photography.

You should see your doctor if you have:

• a spot or sore that doesn’t heal within 4 weeks
• a spot or sore that hurts, is itchy, crusty, scabs over, or bleeds for more than 4 weeks
• areas where the skin has broken down and doesn’t heal within 4 weeks, and you can’t think of a reason for this change

Your doctor can decide whether you need any tests.

• Cancer and its management J Tobias and D HochhauserBlackwell, 2015

• Cancer: Principles and Practice of Oncology VT De Vita, TS Lawrence and SA RosenbergWolters Kluwer, 2018

How Do You Treat Stage 4 Melanoma

The good news is that even stage 4 melanoma can be treated. The sooner the cancer is found, the sooner it can be removed and the higher your chances are for recovery. Stage 4 melanoma also has the most treatment options, but these options depend on:

• where the cancer is
• how advanced the cancer has become
• your age and overall health

How you respond to treatment also affects your treatment options. The five standard treatments for melanoma are:

• surgery: to remove the primary tumor and affected lymph nodes
• chemotherapy: a drug treatment to stop growth of cancer cells
• radiation therapy: the application of high-energy X-rays to inhibit growth and cancer cells
• immunotherapy: treatment to boost your immune system
• targeted therapy: the use of drugs or other substances to attack cancer drugs

Other treatments may also depend on where the cancer has spread to. Your doctor will discuss your options with you to help map out a treatment plan.

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Possible Signs And Symptoms Of Melanoma

The most important warning sign of melanoma is a new spot on the skin or a spot that is changing in size, shape, or color.

Another important sign is a spot that looks different from all of the other spots on your skin .

If you have one of these warning signs, have your skin checked by a doctor.

The ABCDE rule is another guide to the usual signs of melanoma. Be on the lookout and tell your doctor about spots that have any of the following features:

• A is for Asymmetry: One half of a mole or birthmark does not match the other.
• B is for Border:The edges are irregular, ragged, notched, or blurred.
• C is for Color:The color is not the same all over and may include different shades of brown or black, or sometimes with patches of pink, red, white, or blue.
• D is for Diameter:The spot is larger than 6 millimeters across , although melanomas can sometimes be smaller than this.
• E is for Evolving: The mole is changing in size, shape, or color.

Some melanomas dont fit these rules. Its important to tell your doctor about any changes or new spots on the skin, or growths that look different from the rest of your moles.

Other warning signs are:

• A sore that doesnt heal
• Spread of pigment from the border of a spot into surrounding skin
• Redness or a new swelling beyond the border of the mole
• Change in sensation, such as itchiness, tenderness, or pain
• Change in the surface of a mole scaliness, oozing, bleeding, or the appearance of a lump or bump

What You Can Do

Check yourself: No matter your risk, examine your skin head-to-toe once a month to identify potential skin cancers early. Take note of existing moles or lesions that grow or change. Learn how to check your skin here.

When in doubt, check it out. Because melanoma can be so dangerous once it advances, follow your instincts and visit your doctor if you see a spot that just doesnt seem right.

Keep in mind that while important, monthly self-exams are not enough. See your dermatologist at least once a year for a professional skin exam.

If youve had a melanoma, follow up regularly with your doctor once treatment is complete. Stick to the schedule your doctor recommends so that you will find any recurrence as early as possible.

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How Is Melanoma Diagnosed

If you have a mole or other spot that looks suspicious, your doctor may remove it and look at it under the microscope to see if it contains cancer cells. This is called a biopsy.

After your doctor receives the skin biopsy results showing evidence of melanoma cells, the next step is to determine if the melanoma has spread. This is called staging. Once diagnosed, melanoma will be categorized based on several factors, such as how deeply it has spread and its appearance under the microscope. Tumor thickness is the most important characteristic in predicting outcomes.

Melanomas are grouped into the following stages:

• Stage 0 : The melanoma is only in the top layer of skin .
• Stage I: Low-risk primary melanoma with no evidence of spread. This stage is generally curable with surgery.
• Stage II: Features are present that indicate higher risk of recurrence, but there is no evidence of spread.
• Stage III: The melanoma has spread to nearby lymph nodes or nearby skin.
• Stage IV: The melanoma has spread to more distant lymph nodes or skin or has spread to internal organs.

Can Skin Cancer Appear Suddenly

It is the most common type of skin cancer. While basal cell tumors can be small or large, they rarely spread to other parts of the body. Signs include a new or growing bump that is skin colored, pink, or shiny. A growth can develop slowly or appear suddenly.

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How Do People Find Signs Of Melanoma On Their Own Skin

Performing a skin self-exam as often as recommended by your dermatologist is the best way. While examining your skin, you want to look for the following:

• Mole that is changing in any way

• Spot that looks different from the rest of the spots on your skin

• Growth or spot on your skin that itches, bleeds, or is painful

• Band of color beneath or around a nail

• Sore that doesnt heal or heals and returns

The ABCDEs of melanoma can help you find changes to a mole, freckle, or other spot on your skin.

What Are The Symptoms Of Skin Cancer

Talk to your doctor if you notice changes in your skin such as a new growth, a sore that doesnt heal, a change in an old growth, or any of the A-B-C-D-Es of melanoma.

A change in your skin is the most common sign of skin cancer. This could be a new growth, a sore that doesnt heal, or a change in a mole.external icon Not all skin cancers look the same.

For melanoma specifically, a simple way to remember the warning signs is to remember the A-B-C-D-Es of melanoma

• A stands for asymmetrical. Does the mole or spot have an irregular shape with two parts that look very different?
• B stands for border. Is the border irregular or jagged?
• C is for color. Is the color uneven?
• D is for diameter. Is the mole or spot larger than the size of a pea?
• E is for evolving. Has the mole or spot changed during the past few weeks or months?

Talk to your doctor if you notice changes in your skin such as a new growth, a sore that doesnt heal, a change in an old growth, or any of the A-B-C-D-Es of melanoma.

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The Risks The Causes What You Can Do

Skin cancers like melanoma have damaged DNA in skin cells that lead to uncontrolled growth of these cells. Ultraviolet rays from the sun or tanning beds damage DNA in your skin cells. Your immune system repairs some of this damage but not all. Over time, the remaining DNA damage can lead to mutations that cause skin cancer. Many other factors also play a role in increasing the risk for melanoma, including genetics , skin type or color, hair color, freckling and number of moles on the body.

Understanding what causes melanoma and whether youre at high risk of developing the disease can help you prevent it or detect it early when it is easiest to treat and cure.

These factors increase your melanoma risk:

• Unprotected or excessive UV exposure from the sun or indoor tanning.

• Weakened immune system due to a medical condition or medications.

• Many moles: The more moles you have on your body, the higher your risk for melanoma. Also, having large moles , or any atypical moles, increases the risk for melanoma.

• Fair skin: Melanoma occurs more frequently in people with fair skin, light eyes and light or red hair.

• Skin cancer history: People who have already had melanoma or nonmelanoma skin cancers run a greater risk of developing melanoma in the future.

• Genetics: Melanoma can run in families one in every 10 patients has a family member who also has had the disease.