Melanoma
Symptoms
Melanoma typically appears as a new or changing mole with irregular borders, varied color, asymmetry, and diameter larger than 6mm. It may itch, bleed, or ulcerate. Melanoma can occur anywhere on the body, including areas not exposed to the sun. In men, it is more common on the back; in women, on the legs. Acral lentiginous melanoma may appear on the palms, soles, or under the nails. Unlike benign moles, melanomas often evolve over time. Early stages may be subtle and easily missed. Later stages can involve lymph nodes or internal organs.
Cause
Melanoma is primarily caused by UV exposure, especially intermittent, intense sunburns. Genetic mutations (e.g., in BRAF or NRAS genes) play a role. People with numerous moles, atypical nevi, fair skin, or a family history of melanoma are at increased risk. Immunosuppression also increases susceptibility. Unlike other skin cancers, melanoma is more aggressive and likely to metastasize. Indoor tanning significantly increases risk. Early detection is critical for survival.
Treatment
Surgical excision with wide margins is the primary treatment for localized melanoma. Sentinel lymph node biopsy may be performed to check for spread. Advanced cases may require immunotherapy (e.g., checkpoint inhibitors), targeted therapy (e.g., BRAF inhibitors), or chemotherapy. Follow-up includes regular skin exams and imaging in some cases. Sunscreen, protective clothing, and avoiding tanning beds are key prevention measures. Patients with high-risk features may require genetic counseling or dermatologic surveillance.
Dr. Beth Schulz-Butulis
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