Skin Cancer Melanoma

About Skin Cancer Melanoma

Melanoma is the most dangerous type of skin cancer, accounting for approximately 1 percent of skin cancers but the majority of skin cancer deaths. It develops from melanocytes, the pigment producing cells. Hundreds of thousands of new melanomas are diagnosed worldwide each year. Risk factors include UV radiation exposure, fair skin, large number of moles nevi, family history, personal history of melanoma, immunosuppression, and tanning bed use. The ABCDE rule helps identify suspicious lesions: Asymmetry, Border irregularity, Color variation, Diameter over 6 mm, and Evolution changes in size, shape, color, or symptoms. Diagnosis is made through biopsy of suspicious lesions. Treatment for early stage melanoma is surgical excision with appropriate margins. Sentinel lymph node biopsy guides staging for lesions over 0.8 mm thick or with ulceration. Advanced melanoma has been transformed by immunotherapy: checkpoint inhibitors anti PD 1 nivolumab, pembrolizumab and anti CTLA 4 ipilimumab, and targeted therapy for BRAF V600 mutations dabrafenib trametinib, encorafenib binimetinib. These therapies have greatly improved long term survival in advanced melanoma, which was historically very poor. Prevention includes sun protection and avoiding tanning beds. A new or changing mole or skin lesion warrants assessment by a clinician.