Malignant Melanoma is the most aggressive of malignant cutaneous tumours. Cases with lymphonode involvement, and distant metastases, carry a very poor prognosis, (50% and 20% respectively alive in 5 years), while those presenting without evident lymphonode involvement have a much better survival rate (60% alive in 5 years).
It is therefore extremely important to do early malignant melanoma diagnosis. There are several criteria that may lead to the diagnosis of a malignant melanoma. The most important one is the ABCD rule.
The ABCD diagnosis of Malignant Melanoma –
A = Asymmetry: Moles are commonly symmetrical and round. Very early melanomas, are asymmetrical assuming different forms. One half does not match the other half.
B = Border: Commonly moles, have even and smooth borders. Early melanomas, are usually uneven and notched borders.The edges are ragged, notched or blurred.
C = Color: Moles commonly are a single shade of brown, early malignant melanomas shows brown-tan or black color. Further, as melanomas progress, may see red, white, and blue color.
D = Diameter: Early malignant melanomas, differently from moles, tend to grow larger in diameter. First suspects in melanoma start fom, a 6 millimeters diameter on. Any sudden or continuing increase in size should be of special concern.
Synthesis: a mole with diameter of 6 millimeter, that it introduces alterations – irregular asymmetry, edges, color – must induce the patient to address early on dermatologist to careful clinical and dermatoscopic examination and consequently, if necessary, to surgical removal of the lesion, with successive hystological examination.
According to the risk factors for malignant melanoma, the following preventive measures are also recommended:
* UV exposure, should be reduced. Prolonged sunbathing, as well as the use of tanning lamps, is not recommended. Children, under three years of age, should be held in the shade.
* Sun protection, should be obtained through suitable clothing. Children should be peculiarly dressed when playing outside.
* Use adequate sunscreens.
* Sunburns should be avoided, particularly in children.
Therefore people with multiple and abnormal moles, or with a family history of malignant melanoma, should have their skin checked continuously by a doctor or dermatologist to surgical remove the lesion.
Prof. Camillo Di Cicco, MD