Melanocytes, Mole, Melanoma

8/8/2019 Melanocytes, Mole, Melanoma

1/35

Melanocyte, Mole, Melanoma: Back to the basics Deba Sarma, MD, Omaha

Objectives: At the end of the presentation the participant should be able to:

1. Explore the relationship between melanocytes, moles and melanoma.2. Summarize the risk factors for melanoma.

3. Review the preventive measures against melanoma.


2/35

News Headline

Melanoma cases surge among

young women

The incidence of the deadly skin cancer increased by

50% between 1980 and 2004, a study finds. Use of

tanning salons is cited as one possible reason.

Los Angeles Times. July 11, 2008


3/35

On the campaign trail, few mentions of

McCains bout with melanoma

The N Y Times March 9, 2008


4/35

MelanocytesMole

Melanoma

Deba P Sarma, MDDeba P Sarma, MDCreighton University Medical CernterCreighton University Medical Cernter


5/35

Melanocytes


6/35

Melanocyte


7/35

Nevus = Mole

Spot, Beauty markSpot, Beauty mark


8/35

Life of a nevus


9/35

Congenital nevus


10/35

Common nevi

Junctional

Compound

Dermal


11/35

Dysplastic nevus


12/35

Dysplastic nevus


13/35

Types

Melanoma in situMelanoma in situ

Melanoma (Invasive melanoma)Melanoma (Invasive melanoma)

Melanoma


14/35

Lentigo maligna melanomaLentigo maligna melanoma

Superficial spreading melanomaSuperficial spreading melanoma

Nodular melanomaNodular melanomaAcral lentiginous melanomaAcral lentiginous melanoma

Desmoplastic melanomaDesmoplastic melanoma

Melanoma


15/35

Lentigo maligna melanoma


16/35

Superficial spreading melanoma


17/35

Nodular melanoma


18/35

Acral lentiginous melanoma


19/35

Estd new cancer cases, USA, 2008American Cancer Society

Male: Female:

1. Prostate (25%) 1. Breast (31%)

2.L

ung (15%) 2.L

ung (14%)3. Colorectum (10%) 3. Colorectum (10%)

4. Bladder (7%) 4. Uterus (5%)

5. NH Lymphoma (5%) 5. NH Lymphoma (4%)

6. Melanoma (5%) 6. Thyroid (4%)

7. Kidney (4%) 7. Melanoma (4%)


20/35

Estd new melanoma cases, 2008American Cancer Society, 2008

USA : total 116,500USA : total 116,500

( In situ 54,000 Invasive 62,500 )( In situ 54,000 Invasive 62,500 )

NEBRASKA: 380 ( Invasive melanoma)NEBRASKA: 380 ( Invasive melanoma)

Estd deaths from melanoma, 2008

USA 8500USA 8500

NEBRASKA 50NEBRASKA 50


21/35

Risk factors

Uncontrollable:

Skin type (race)

History of melanoma

Moles and atypical moles

Age: 70 +

Gender: M > F

Controllable:

UV radiation ( sunlight, tanning booths and lamps)


22/35

Skin types

V VIIV

I II III


23/35

History of melanoma

FirstFirst--degree relatives: Father, mother,degree relatives: Father, mother,

brother, sister, childbrother, sister, child

Personal history of melanomaPersonal history of melanoma

Melanoma pt.: Family history in 10%.Melanoma pt.: Family history in 10%.


24/35

Common acquired nevi,

atypical nevi

Normal nevi Abnormal neviNormal nevi Abnormal nevi

Age: 2 Age: 2--3030 New mole after 30New mole after 30

Number: 20Number: 20--3030 Number: >50Number: >50Atypical mole: >5Atypical mole: >5

Familial dysplastic moleFamilial dysplastic mole

syndromesyndrome


25/35

Sun


26/35

Protection from UVA UVB

Seek shade, avoid outdoors: 10am to 4pm

Protective clothing

Wraparound sunglasses, broad-brimmed hats

Sunscreen, broad spectrum, at least 15 SPF

No tanning booth or sun lamp


27/35

Melanoma Prevention

Moles: Professional screening

Self-examinationNew mole after 30

Changing mole


28/35

Danger signs

ABCD


29/35

CML Melanoma

12 months: 3/1/07-3/1/08

Total cases: 56 Male: 36 Female: 20Total cases: 56 Male: 36 Female: 20

Age: 27Age: 27--9595

Male: 50: 29Male: 50: 29

Female: 50: 13Female: 50: 13


30/35

Melanoma sites


31/35

Sites

Head & neck: 20 ( Male 18, Female 2)

Upper limb: 4 ( Male 2, Female 2)

Lower limb: 12 ( Male 2, Female 10) Trunk: 20 ( Male 14, Female 6)


32/35

Types

Melanoma in-situ: 20

Lentigo maligna 8, Pagetoid 12

Superficial spreading melanoma: 23

Lentigo maligna melanoma: 4

Nodular melanoma: 5

Desmoplastic melanoma: 2 Recurrent melanoma: 2


33/35

Five-year survival rate

Overall 90%Overall 90%

Localized 99%Localized 99%

With regional spread 45%With regional spread 45%

Good news: 80% localized at diagnosisGood news: 80% localized at diagnosis


34/35

Editorials 1985-2008

Ackerman AB. No one should die of

malignant melanoma. J Am Acad

Dermatol. 1985 Jan; 12: 115-6.

Kittler H. Early recognition at last. Arch

Dermatol. 2008 April;144: 533-4.


35/35

Documents

Melanocytes, Mole, Melanoma