Melanoma: Difference between revisions
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*Ultraviolet UVB light (315 – 280 nm) from sun/tanning beds damages DNA | *Ultraviolet UVB light (315 – 280 nm) from sun/tanning beds damages DNA | ||
*High risk in fair skin, blue eyes, and red-haired people, | *High risk in fair skin, blue eyes, and red-haired people, | ||
*High risk | *High risk history of multiple atypical nevi or dysplastic nevi | ||
==Clinical Features== | ==Clinical Features== | ||
[[File:Melanoma.jpg|thumb|Classic melanoma.]] | |||
[[File:MelanomavsNormal.jpg|thumbnail|On the left side from top to bottom: melanomas showing (A) Asymmetry, (B) a border that is uneven, ragged, or notched, (C) coloring of different shades of brown, black, or tan and (D) diameter that had changed in size compared to normal moles on the right.]] | |||
*'''A'''symmetry | *'''A'''symmetry | ||
*'''B'''orders (irregular) | *'''B'''orders (irregular) | ||
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*'''D'''iameter (greater than 6 mm (0.24 in), about the size of a pencil eraser) | *'''D'''iameter (greater than 6 mm (0.24 in), about the size of a pencil eraser) | ||
*'''E'''volving over time or '''E'''levated above the skin | *'''E'''volving over time or '''E'''levated above the skin | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Dermatologic malignancies DDX}} | {{Dermatologic malignancies DDX}} | ||
{{DDX dark raised lesions}} | |||
== | ==Evaluation== | ||
*Biopsy | *Biopsy outpatient at dermatology office | ||
*LDH ( | *LDH (elevated indicates metastasis, particularly to the liver, not sensitive) | ||
*Imaging for metastasis | *Imaging for metastasis | ||
**CXR or CT | **[[CXR]] or CT | ||
**MRI, PET and/or PET/CT scans | **MRI, PET and/or PET/CT scans | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
[[Category: | [[Category:Dermatology]] | ||
[[Category:Heme/Onc]] | |||
Latest revision as of 18:20, 10 September 2020
Background
- Ultraviolet UVB light (315 – 280 nm) from sun/tanning beds damages DNA
- High risk in fair skin, blue eyes, and red-haired people,
- High risk history of multiple atypical nevi or dysplastic nevi
Clinical Features
- Asymmetry
- Borders (irregular)
- Color (variegated)
- Diameter (greater than 6 mm (0.24 in), about the size of a pencil eraser)
- Evolving over time or Elevated above the skin
Differential Diagnosis
Dermatologic malignancies
Dark raised skin lesions
Evaluation
- Biopsy outpatient at dermatology office
- LDH (elevated indicates metastasis, particularly to the liver, not sensitive)
- Imaging for metastasis
- CXR or CT
- MRI, PET and/or PET/CT scans
Disposition
- Refer to dermatology
Prevention
- Avoid UV radiation: hats, long sleeve shirts, sunglasses with UV protection
- Even though tanning beds mostly UVA, still can cause melanoma
- Sunscreen
- Blocks damaging UVB radiation
- Sun Protectant Factor (SPF) of 15 means if you notice a burn at 10 min, applying SPF 15 would allow you to stay out 150 min before noticing burn
- SPF >30 if outside work or long time recreation and reapply as needed