Melanoma (melanoblastoma, neocarcinoma) is malignant
swelling of the skin that occurs when cells are reborn
melanocytes. These cells are normally synthesized under
the action of ultraviolet – the pigment melanin. Human skin color
causes both the number of melanocytes and the number
melanin produced by them. Melonom may also occur
of moles (nevi) that most people have, since
melanocytes accumulate in large quantities in nevi:
pigment and melanocytic.
The term “melanoma” consists of two parts and is derived from
Greek “melanos” (dark, black) and “oma” – a tumor.
Cases of non-pigmented melanoma that occur are described.
very rarely, however, in practice such options are still
have met.
In most cases, the tumor is localized on the skin,
but also found on the mucous membranes of the mouth, the eyeball,
on the internal organs and on the female genital organs. Also
There are various non-standard forms of melanoma. For example,
there is a form which is expressed by the appearance on the skin of a simple
dots are black or brown, and the other shape is a strip
under the nail, or the tumor looks more like a bruise.
In most cases, melanoma develops in older people with I
Fitzpatrick skin phototype II and III, but this does not mean that
young people and people with darker skin are not at risk
melanoma development. Sometimes melanoma develops from nevi,
existing for a long time on the skin, but, as practice shows, 70%
cases of melanoma arise from newly formed pigment spots,
which was not previously. Unfortunately, melanoma is already diagnosed on
stages of metastasis, but even the early diagnosis of the disease is not
leaves a chance for a favorable outlook due to the extreme
aggressiveness and malignancy of the tumor.
Unfortunately, the statistics gives us disappointing
results. Every year the number of people with melanoma
will grow. According to WHO, 9480 people will die from melanoma in the future.
(about 6280 men and 3200 women).
Content
- Melanoma forms
- Symptoms of the disease
- What contributes to the development of melanoma?
- Who is at risk?
- Diagnosis of Melanoma
- Stages of melanoma
- Treatment methods
- Prognosis and prevention
Contents
Melanoma forms
Melanoma can have the following forms:
- surface spreading;
- malignant lentigo-melanoma;
- acral melonoma;
- nodal.
Superficial spreading melanoma (flat melanoma).
This form of melanoma develops from a pigmented nevus or on
normal skin. It is localized both on open, and on closed
skin areas. In women, mainly on the lower limbs, in
men on the upper back. Has a plaque shape with fuzzy
borders, signs of keratosis on the surface, multicolored
color: the tumor may contain both dark and blue, pink
shades. This form of melanoma is more common and is 75
% of all melanomas of the skin.
Malignant type of malignant lentigo for a long time
long stage of horizontal growth. This form of melanoma
is found in older people in the open areas of skin in the form of plaques
or dark spots and is considered less aggressive than
other forms. This form of melanoma is 13% of all melanomas
skin.
Acral melanoma develops at the base of the nail plate.
The main symptom of this form of melanoma is a dark spot under
a nail that does not immediately alarm the patient and thereby
allows you to diagnose the disease. This form
The disease accounts for no more than 8% of all melanomas.
Nodular melanoma is considered the most aggressive form.
malignant melanoma. It is 30% of all cases of this
pathology. This form of melanoma develops from primary
a source that has arisen out of the blue where there are never moles
It was. Symptoms of this form appear more often as a single
node, less multiple formations. There is a rapid growth of the node,
bleeding and ulceration. Specific localization on the back,
neck, head, lower and upper limbs. Histological
the study shows a large accumulation of atypical melanocytic
cells that spread to different depths of the skin.
Symptoms of the disease
Although each form of melanoma has its own
specific symptoms, there are a number of common symptoms
characteristic of all forms of melanoma. What are the signs
characterized by melanoma?
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- The rapid growth of the tumor: an increase of several times in
several months. - Heterogeneous pigmentation: melanoma is usually characterized by
mosaic coloring. - Asymmetric form of a tumor with torn fuzzy edges.
- Painful sensations.
- Bleeding and ulceration of moles.
- Hair loss, if early hair grew on it.
When examining skin tumors can be used
“rule ABCDE”, which allows you to diagnose melanoma on
Early development:
- asymmetry;
- blurred boundaries;
- mosaic coloring;
- elevation of the tumor over the skin;
- change in symptoms: a mole changes its
specifications.
Attention! If you find yourself having one or more of
“ABCDE rules” urgently needs to be consulted
dermatologist.
Most often, melanoma in the early stages causes no
subjective sensations, but sometimes the patient experiences the following
signs:
- bleeding;
- burning;
- itching;
- soreness
What contributes to the development of melanoma?
The main cause of melanoma is prolonged exposure.
UV radiation on the skin. With the harmful effects of ultraviolet radiation on
the skin is damaged by DNA that provokes somatic mutagenesis
skin cells. Over time, mutations in DNA accumulate, which
initiates the development of a cancer. Also provoke melanoma
The following factors can:
- UV radiation;
- advanced age;
- ionizing radiation;
- hereditary factor and genetic predisposition;
- nevus damage;
- prolonged exposure to the body of toxic agents.
There are cases of melanoma as a result of birth injury.
stains. In addition, there are cases when the occurrence of melanoma
provoked the intentional removal of a nevus. There is an opinion,
that the development of melanoma may be due to a hormonal imbalance
system and the effect of certain hormones on melanoma growth.
Also an important role in the development of melanoma plays
hereditary factor, there are so-called “melanoma
families”.
In this case, it is necessary to mention the dangers of tanning beds. Solarium
can cause the development of melanoma much more often than the natural
ultraviolet irradiation. What is the reason?
First, in solariums, no one controls the power of the lamps.
Secondly, tanning creams are used in tanning.
It turns out, instead of being protected from ultraviolet radiation, its
intensity increases several times.
Who is at risk?
The risk group includes people with the following symptoms and
states:
- people with Fitzpatrick I, II and III skin phototype;
- persons who, by virtue of professional employment in the air or
excessively abused sunbaths for a long time
time (this group of risk includes children); - persons whose families had cases of melanoma;
- persons who have a large accumulation of moles on the body, as well as children,
having more than 50 moles; - persons with serious skin damage in the past (burns,
scars, trophic ulcers); - elderly people who have keratosis;
- skin precancer (Bowen disease, cutaneous hormone, blue nevus,
Paget’s disease, pigment xerodem).
Diagnosis of Melanoma
Usually, the diagnosis of melanoma is established on the basis of morphological
microscopic examination of tissue sections. In other words
biopsy of the removed tissue is performed. In the case of the presence of the statement
tumors performed histological examination, allowing for accurate
diagnose melanoma before surgery. TO
an expressed tumor is applied a glass for a smear on which
imprinted trace of the wound. Smear imprint microscopically and
determine the exact diagnosis.
Also carry out the puncture of the inflamed increased
lymph node in conjunction with ultrasound
Ultrasound, to determine the spread of the process (development
metastasis).
If there is doubt about the accuracy of the diagnosis,
additional research – urgent excision biopsy
intraoperative histological examination. When
confirmation of the diagnosis of the results of a biopsy immediately
surgical intervention is carried out.
At the same time, an X-ray examination is being conducted.
chest organs, ultrasound of the abdominal organs, regional
lymph nodes, as well as osteoscintigraphy in case of symptoms
lesion of the skeletal system. In the presence of symptoms of damage
brain scans performed by MRI
(magnetic resonance imaging) and CT (computerized
tomography).
Stages of melanoma
The stages of skin melanoma are based on cytological
remote tumor studies. Melanoma has the following stages
development:
Zero stage. Melanoma is a non-invasive
malignant lesion.
The first stage. In this case, melanoma without expressions has
thickness not less than 1 mm, and with ulceration not more than 2 mm
Second stage Melanoma without manifestations with a thickness of more than 2, without
expressions up to 2 mm thick
The above stages are not characterized by the formation of foci.
metastasis of internal organs. In the next two, these foci
already present.
The third stage is characterized by the presence of metastases in regional
lymph nodes.
The fourth stage is characterized by the presence of metastases in
distant organs and tissues of the body.
Treatment methods
Melanoma treatment is carried out depending on the stage.
diseases. In cases of melanoma with metastases, only
lymph nodes and melanoma without metastases are performed
surgical treatment of the tumor. In the treatment of metastatic stages
Melanomas use the following treatment methods:
- surgical method;
- chemotherapeutic method;
- radiation therapy;
- immunotherapy;
- general hyperthermia;
- photodynamic therapy.
Surgery. Surgical removal of the tumor is
the main treatment for melanoma. The tumor itself is removed along with
surrounding tissue and subcutaneous tissue. The lymph nodes
excised only in case of their defeat by metastases.
Radiation therapy. In case of failure to remove metastases
radiation therapy is performed surgically, as well as after
removal of large metastases to prevent recurrence.
Chemotherapy and immunotherapy. Unfortunately, modern medicine
does not have effective remedies for treating metastases
melanomas of the skin, therefore in order to prevent recurrence they use
chemotherapy.
The remaining methods are not dominant in the treatment of
melanomas, but they are able in some cases to slow down its development,
suspend the growth of metastases and even reduce it
sizes.
General hyperthermia (GBS). This method is used in the treatment of
metastases of internal organs. This method is not used when
metastases located in the brain, on the head and neck. In what
the essence of the method? The human body is heated by an electromagnetic field with
administering an anticancer drug. In some cases, when
treatment of GHT malignancy is reduced in size and
ceases to progress. This phenomenon is observed even with
chemotherapy she used to be
insensitive.
Photodynamic therapy (PDT). PDT does not cure
melanoma, but provides local antitumor therapy. Apply
this method for the treatment of intradermal metastasis.
Prognosis and prevention
Unfortunately, this form of skin cancer is the most aggressive and
characterized by poor projections. Even with timely
appeal to the doctor and the behavior of adequate treatment, the disease
by no means always ends with a favorable outcome. In most
In cases of disease outcome depends on the stage of development of melanoma. Than
the thicker the melanoma, the higher the risk of a terminal condition. In the early
the stage of the disease melanoma may well be treatable.
Disease prevention consists of adhering to several
rules:
- protect your skin from ultraviolet radiation by
sunscreens with high protection factor; - avoid tanning beds, especially for people with multiple
nevi on the skin; - limit sun exposure: until 10 am and after 17 days
time; - avoid damages and injuries of moles;
- use natural sun protection: relax in the shade
trees wearing light, light clothing covering large
perimeter of the skin; - use sunscreen even in those cases where you
stay in the sun for a short time. - do not forget to wear hats, panama and glasses;
- people at risk are systematically observed in
dermato-oncologist; - independently monitor the state of moles.
It should be remembered that tanned skin is far from a sign of beauty and
health The phrase “healthy tan” is an oxymoron, since
tanning can not be healthy. Sunburn is our response
organism on the harmful effects of ultraviolet radiation. Ultraviolet
radiation is damage to the skin that causes at best
photo-aging and, at worst, deadly diseases such
such as: basalioma, adenocarcinoma, squamous cell carcinoma and
melanoma of the skin.
