melanoma

What is Melanoma?

Melanoma is a serious form of skin cancer that develops in cells called melanocytes, which produce the pigment melanin that gives skin its color [1]. It starts in these cells and can spread to other parts of the body if left untreated [6].

Causes and Risk Factors

Melanoma is caused by changes (mutations) in skin cells called melanocytes, leading to uncontrolled growth and division [7]. While it's less common than basal cell carcinoma, melanoma is more aggressive and can be fatal if not treated promptly.

Characteristics of Melanoma

• Uncontrolled Growth: Melanoma grows rapidly and uncontrollably, unlike normal cells that grow and divide in a controlled manner.
• Pigment-Producing Cells: Melanoma arises from melanocytes, which produce the pigment melanin.
• Serious Form of Skin Cancer: Melanoma is considered a serious form of skin cancer due to its potential to spread and cause death if left untreated.

Types of Melanoma

While there are different types of melanoma, they all originate from melanocytes. The most common type is cutaneous melanoma, which affects the skin [8].

Symptoms and Detection

Early detection is crucial in treating melanoma. Symptoms may include a new mole or a change in an existing one, such as its size, shape, color, or texture [9]. If you notice any unusual changes on your skin, consult a dermatologist for proper evaluation.

References: [1] Dec 30, 2023 — Melanocytes are cells that make the pigment that gives skin its color. [2] Oct 27, 2023 — Melanocytes (the cells that give the skin its tan or brown color) start to grow out of ... [6] Melanoma skin cancer is when abnormal cells in the skin start to grow and divide in an uncontrolled way. It starts in skin cells called melanocytes. [7] Feb 15, 2024 — Melanoma is caused by changes (mutations) in skin cells called melanocytes. These cells make a skin color pigment called melanin. [8] Malignant melanoma arises from melanocytes in a pigmented area (eg, skin, mucous membranes, eyes, or central nervous system). Metastasis is correlated with ... [9] Oct 23, 2024 — A. Melanoma, the most serious form of skin cancer, is characterized by the uncontrolled growth of pigment-producing cells.

Understanding Melanoma Signs and Symptoms

Melanoma, a type of skin cancer, can manifest in various ways on the skin. Identifying its signs and symptoms is crucial for early detection and treatment.

• Asymmetrical shape: Moles with unusual shapes, such as two very different-looking halves, may indicate melanoma [1].
• Changes in size, shape, color, or elevation: Any change in a spot on your skin, including bleeding, itching, or crusting, can be a warning sign of melanoma [5].
• New mole or change in an existing mole: A new mole or a change in the size, shape, color, or height of an existing mole may be signs of melanoma [6][7][8].
• Itching, bleeding, oozing, and/or crusting: These symptoms can indicate late-stage melanoma [2].

Common Signs and Symptoms

Some common signs and symptoms of melanoma include:

• A new mark on the skin
• A mole that changes size, shape, color, or height
• Skin lesions, discoloration, or abnormal pigmentation
• Skin swelling

It's essential to note that most melanomas don't give you symptoms like pain or itching. Some non-cancerous (benign) moles or abnormal patches of skin can be itchy [3]. A change in your skin is the most common sign of skin cancer, which could be a new growth, a sore that doesn't heal, or a change in a mole [4].

References

[1] Signs that may indicate melanoma [2] Understanding late-stage melanoma [3] Most melanomas don't give you symptoms like pain or itching. [4] A change in your skin is the most common sign of skin cancer. [5] Any change in size, shape, color or elevation of a spot on your skin, or any new symptom in it, such as bleeding, itching or crusting, may be a warning sign of ... [6] Main symptoms of melanoma skin cancer [7] Common signs and symptoms of melanoma skin cancer include a new mark on the skin and a mole that changes size, shape, colour or height. [8] What are the signs and symptoms of melanoma?

Diagnostic Tests for Melanoma

Melanoma diagnosis involves various tests to confirm the presence and extent of cancer in the skin. Here are some diagnostic tests used for melanoma:

• Skin Exam: A thorough examination of the skin by a dermatologist or healthcare provider is the first step in diagnosing melanoma. They check for moles, birthmarks, or other pigmented areas that look abnormal in color, size, shape, or texture [4].
• Biopsy: A biopsy involves taking a small sample of tissue from the suspicious area and examining it under a microscope to confirm the presence of cancer cells [5]. During a biopsy, the doctor may also take a sample of lymph nodes to check for melanoma spread.
• Imaging Tests: Imaging tests such as X-ray, MRI, CT scans, and PET scans are used to stage melanoma and determine if it has spread to other parts of the body. These tests help doctors understand the extent of cancer and plan treatment accordingly [2][8].
• Sentinel Lymph Node Biopsy: This test is used to check if melanoma has spread to nearby lymph nodes. A small sample of tissue from the sentinel lymph node (the first lymph node to which cancer cells are likely to spread) is examined under a microscope [7].

Non-Invasive Tests

Some non-invasive tests can help doctors and patients decide whether to biopsy a suspicious skin lesion, such as:

• DermTech Melanoma Test: This test uses a small device to collect a sample of skin cells from the suspicious area. The sample is then analyzed for genetic markers associated with melanoma [6].

References

[1] Oct 27, 2023 — Blood tests aren't used to diagnose melanoma, but some tests may be done before or during treatment. [2] Dec 30, 2023 — Tests might include X-ray, MRI , CT and positron emission tomography, which is also called a PET scan. [3] Chest X-ray · Lymphoscintigraphy · Ultrasound · CT or CAT (computed axial tomography) scans · MRI (magnetic resonance imaging) scans · PET (positron emission ... [4] Initial Diagnosis · A skin exam checks for moles, birthmarks, or other pigmented areas that look abnormal in color, size, shape, or texture. [5] Tests to diagnose melanoma, such as biopsy, are done when symptoms suggest a problem or a doctor suspects melanoma. [6] One example of a non-invasive test that can help doctors and patients decide whether to biopsy a suspicious skin lesion is the DermTech Melanoma Test (DMT). [7] What tests are used to stage melanoma? · Sentinel Lymph Node Biopsy: · Computed Tomography (CT) scan: · Magnetic Resonance Imaging (MRI) scan: · Positron Emission ... [8] Aug 27, 2024 — Doctors use CT or MRI scans to check if the melanoma has spread. Not everyone will need these. [9] Doctors at NYU Langone's Perlmutter Cancer Center diagnose melanoma through an examination of the skin and a biopsy, in which a small sample of tissue is ... [10] The specialist will check your skin and ask you about any changes you've noticed. They may use a magnifying device that lets them look at the skin more closely.

Melanoma Drug Treatments

Melanoma, a type of skin cancer, can be treated with various drugs to manage its progression and improve patient outcomes. Here are some key points about drug treatments for melanoma:

• Targeted Therapy: Targeted therapy drugs, such as BRAF inhibitors (e.g., dabrafenib) and MEK inhibitors (e.g., trametinib), are often used in combination to treat melanomas with specific genetic mutations [5]. These combinations have shown improved response rates compared to single-agent therapies.
• Checkpoint Inhibitors: Checkpoint inhibitor drugs, such as ipilimumab, nivolumab, and pembrolizumab, work by stimulating the body's immune response to attack cancer cells. These immunotherapies are approved for treating advanced melanoma [7].
• Chemotherapy: Chemotherapy agents like carboplatin, cisplatin, dacarbazine, and vinblastine have been approved for treating melanoma, although their use is generally limited to more advanced cases [4][8].
• Cellular Therapies: Amtagvi (Lifileucel) has been approved as the first cellular therapy for adults with unresectable or metastatic melanoma previously treated with other therapies [3].

Commonly Used Melanoma Drugs

Some commonly used drugs in treating melanoma include:

• Aldesleukin
• Amtagvi (Lifileucel)
• Atezolizumab
• Binimetinib (Mektovi)
• Cobimetinib (Cotellic)
• Dacarbazine (DTIC-Dome)
• Paclitaxel (Abraxane)

References

[1] Drugs Approved for Melanoma. [2] MEK inhibitors include trametinib (Mekinist), cobimetinib (Cotellic), and binimetinib (Mektovi). [3] The FDA approved Amtagvi, the first cellular therapy for the treatment of adults with unresectable or metastatic melanoma previously treated ... [4] Chemotherapy · Carboplatin (Paraplatin, CARBOplatin Novaplus) · Cisplatin (Platinol, Platinol-AQ) · Dacarbazine (DTIC-Dome) · Paclitaxel (Abraxane) [5] These melanomas often respond to treatment with targeted therapy drugs – typically a combination of a BRAF inhibitor and a MEK inhibitor. [6] Dabrafenib and trametinib are targeted cancer drugs for melanoma skin cancer and non small cell lung cancer (NSCLC). [7] Three checkpoint inhibitor drugs are currently available to treat advanced melanoma. These are ipilimumab (Yervoy®), nivolumab (Opdivo®), and pembrolizumab ( ... [8] Pegylated interferon and the chemotherapy agents dacarbazine, cisplatin, and vinblastine are approved by the US Food and Drug Administration ( ...

Differential Diagnosis of Melanoma

Melanoma, a type of skin cancer, can be challenging to diagnose due to its similarity in appearance to benign lesions. The differential diagnosis of melanoma involves considering various conditions that may present with similar symptoms.

Common Differential Diagnoses:

• Benign Melanocytic Lesions: These are non-cancerous growths on the skin that can resemble melanomas. They include:
  • Benign pigmented nevi (moles) [5]
  • Seborrhoeic keratosis [6]
  • Benign melanocytic naevi [4, 6]
• Dysplastic Nevus: A type of mole that is considered atypical and may be a precursor to melanoma. However, not all dysplastic nevi are cancerous [1].
• Squamous Cell Carcinoma: A type of skin cancer that can appear as a firm, red nodule or a flat, scaly patch [1].
• Metastatic Tumors to the Skin: Cancer cells from other parts of the body can spread to the skin and mimic melanoma [1].

Other Considerations:

• Atypical Fibroxanthoma (AFX)/Undifferentiated Pleomorphic Sarcoma: A rare type of cancer that can appear as a firm, red nodule or a flat, scaly patch [2].
• Desmoplastic (Sclerotic) Nevus: A rare type of mole that can be difficult to distinguish from melanoma [3].

Key Factors in Differential Diagnosis:

• Increasing Age: The risk of melanoma increases with age [4].
• Previous Invasive Melanoma or Melanoma in Situ: Individuals with a history of skin cancer are more likely to develop melanoma [4].
• Multiple (> 50) Melanocytic Naevi (Moles): Having many moles can increase the risk of developing melanoma [4].

References:

[1] Oct 14, 2024 — Diagnostic Considerations [2] by A Fernandez-Flores · 2023 · Cited by 4 [3] Mar 22, 2022 — Differential Diagnoses [4] Increasing age; Previous invasive melanoma or melanoma in situ; Previous basal cell or squamous cell carcinoma; Many melanocytic naevi (moles); Multiple (> ... [5] by G McNeer · 1965 · Cited by 2 [6] by C McCourt · 2014 · Cited by 120