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Melanoma (cont.)

What Are Symptoms and Signs of Melanoma?

Melanomas most often arise on normal skin, but they may also occasionally occur in conjunction with a benign nevus (beauty mark or birthmark). The identification of potentially malignant pigmented lesions is best remembered by using the first five letters of the alphabet as follows:

  • A for asymmetry
  • B for border irregularity
  • C for color multiplicity
  • D for diameter greater than ¼ inch
  • E for evolution (change) in the size and/or shape

Melanomas may ulcerate and bleed and occasionally cause these lesions to itch or burn. In summary, melanomas are most often pigmented, asymmetric with respect to color and shape, and tend to enlarge or change over time. The presence or absence of hair follicles is of no significance.

Metastatic melanoma produces effects depending on the affected organ. In the brain, it can cause headaches and seizures. In the lungs, it causes shortness of breath and malaise. In the bones, it causes bone pain and fractures. It can affect any area of the body. Although rare, melanomas can arise in tissue other than skin at any site that contains melanocytes. This includes the eye (uveal melanomas), mucosa (genital or oral tissues), and in the brain.

What Are Risk Factors for Melanoma?

  • Having light skin
  • Living closer to the equator
  • Having a large number of nevi (moles)
  • Having a personal or family history of melanoma
  • "Dysplastic nevus syndrome," characterized by an inherited predisposition to develop numerous, large irregularly pigmented moles
  • The presence of a very large congenital (present at birth) mole (bathing trunk congenital nevus)

When Should Someone Seek Medical Care for Suspicious Skin Lesions?

There are many kinds of benign pigmented lesions normally found on the skin. Some are present from the time of birth (congenital) while others develop after birth. Commonly, these are referred to as "moles." In younger patients, most pigmented lesions are melanocytic nevi composed of benign melanocytes growing in nests or clumps within the skin. The average number of these lesions is 30-35 per person in light-skinned races. It is not uncommon for such lesions to continue to arise until 35 years of age. Older individuals predominantly have non-melanocytic pigmented lesions called seborrheic keratoses, which arise in the most superficial layer of the skin and tend to continue to appear during adult life. Distinguishing these benign lesions from more ominous ones may be difficult. Any asymmetrical (color or border), changing lesion, especially if it is bleeding or irritated or symptomatic, should be examined by a physician. Regular self-examination or examination by a significant other can be a valuable asset in early detection.

Medically Reviewed by a Doctor on 7/28/2016

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