Melanoma

  • Most dangerous type of skin cancer

  • High chances of spreading to other areas of the body including brain and lungs and other organs

  • Develops quickly – normally changes appearance over a few months

  • May occur in any area of the body including non-sun exposed areas like sole of the feet, buttock, arm pits, nails and other non-exposed areas

  • Can arise from old moles or as a new spot on an area that previously did not have any moles

  • Several different types of melanomas exist

  • Prognosis/survival rate will depend on type of melanoma and stage of melanoma (normally the deeper the worse)

  • Identifying melanomas at an early stage is a key part to having a high chance of survival

  • A person identified with a melanoma is more than 2 times more likely to have another melanoma

  • A partial biopsy should not be performed on a lesion suspicious for melanoma - the suspicious lesion should invariably be completely removed and sent for histology for analysis

  • If identified, on initial removal patients will almost invariably need to undergo wide excision of the area and may need to be investigated for spread (metastasis)

 

How to identify a melanoma

 

  • Melanomas may present in a multitude of different shapes, colours and aspects

  • In general the ABCDE rule (see below)  is encouraged for patients to monitor their own moles

  • Having regular skin checks and seeking medical attention as soon as possible is vital to help identify melanomas early

  • Ideally you should seek a GP that has vast experience in the identification and management of skin cancers as these lesions can be very hard to diagnose and doctors that are not experienced may easily miss them. At LDS cosmetic Dr Lucas de Siqueira performs the examinations and has been doing so for many years and provide a wealth of expertise in this field

  • A full body skin check should be performed and all the lesions should be examined with a medical equipment called a dermoscope which will facilitate the visualisation of the lesions by the Dr.

 

The ABCDE rule

 

  • This is a rule created for patients to try and identify suspicious lesions and seek medical attention asap

  • It does not exclude the need to do regular skin checks and these should still be performed regularly - during these the skin doctor will not rely on the ABCDE rule and will look for other features on dermoscopy examination to determine whether a lesion needs to be removed or not. 

  • It is based on the patient identifying a few different abnormalities on their spots:

 

  • Asymmetry  (A)

  • Borders – irregular (B)

  • Colours – multiple/different shades (C)

  • Diameter – large/growing (D)

  • Evolution – any rapid changes over time (E)

    • Evolution includes changes in size, shape, colour, texture, itching, bleeding, etc)

These are examples of lesions that demonstrate the classic ABCDE rule features (macroscopic and dermoscopic images provided)

A: asymmetry (if we draw a line through the middle of the lesion one side will be different to the other)

B: the borders of the lesions are irregular

C: multiple colours can be seen 

D: large lesions

E: can't be assessed - needs history

Despite being of great value for patients to identify possible melanomas, unfortunately many lesions will not present with these features and will only be able to be diagnosed with proper dermoscopy evaluation by an experienced skin cancer Dr like Dr Lucas de Siqueira. It is the case of nodular melanomas which are the some of the most aggressive forms of melanomas and can rapidly spread to other areas. These lesions normally do not follow the ABCDE pattern as you can see on the next image. 

Can you spot the melanoma on the picture below? Without the use of a dermoscope it is hard. There are a lot of lesions and it might be very hard to know which one might be suspicious. 

But with adequate dermoscopy we are able to determine which lesions have suspicious features despite not having the classic ABCDE features and have the lesion removed. 

Remembering they can be found on any parts of the body.

All photos are courtesy of Dr Lucas de Siqueira

Our Locations:

Altona Superclinic

1 Central Avenue

Altona Meadows, Vic

Ph: 03 93608200

https://www.ipn.com.au/gp/vic-altona-meadows-altona-superclinic/

Moone Ponds Superclinic

45 Hall Street,
Moonee Ponds, Vic

Ph: 03 99764200

https://www.holisticmc.com.au/moonee-ponds/

Agora Specialist Centre

Level 9, Suite 9.1, 89 Bridge Road 

Richmond, Vic

Ph: 03 94212533

https://www.agoracentre.com.au/

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