MALIGNANT MELANOMA

A malignant melanoma is the most dangerous malignant skin tumour. It develops through degeneration of the pigment producing skin cells (melanocytes). Because of its often black or dark-brown colour it is called "black skin cancer".

Two-thirds of malignant melanoma develop on inconspicuous skin, one-third on nevus-cell-nevi (moles, birthmarks). A temporally variable phase of horizontal growth is followed by nodular (vertical) growth with a high risk of metastases. Clinically or dermatoscopically suspect nevi should be excised preventive. 

Reasons for Development 

Risk factors for malignant melanoma are a high number of sunburns in childhood and youth, many nevus-cell-nevi, malignant melanoma in the family history especially in first-degree relatives or light skin type. Other risk factors for the development of skin tumours consist in long-term medicamentous immunosuppression, for example in organ transplant patients, or artificial UV-radiation like tanning booths or therapeutic UV-radiation, for example in psoriasis or atopic dermatitis patients. People with out-door-occupation or other out-door-activities like aquatic sports, hiking, cycling or rock climbing are also at higher risk.  

A well proven help for the early diagnosis of Malignant Melanoma is the “ABCD rule”. This rule is very helpful in judgement of suspect pigment marks and can even be used in the self examination of the skin. 

The Nodular Malignant Melanoma is the most dangerous type of malignant melanoma: it grows early in depths and can metastasize through ingrowths in blood vessels. Since nodular malignant melanoma can be of smaller diameter than 3/16 inches, the ABCD-rule may not be as helpful as in other types of melanomas. Nodular malignant melanoma is dark, bluish or black nodules or nods with an inclination to bleed.

The acrolentiginous melanoma appears merely on hands or feet, it can be localized underneath the nails. Sometimes it is misdiagnosed as wart or haematoma but one can find in progress dark spots in the surrounding. 

Mostly malignant melanoma develop on visible areas of the skin, very rarely they develop on mucous membranes or internal organs. About 70 percent of malignant melanoma appear as superficial spreading malignant melanoma. At the beginning they appear as irregular shaped monochromatic or multicoloured mark. In progress dark nodules may appear or the mark may lose the pigmentation. These signs are not good, you should see your dermatologist immediately. You can find superficial spreading malignant melanoma mostly in areas of the skin, which are not regularly exposed to the sunlight. In male patients they appear mostly on the back, in female patients on the lower legs.

On the chronically sun exposed facial skin of elder people one can find the lentigo maligna melanoma, its incidence accounts for about ten percent of malignant mMelanoma.