Types of benign and malignant melanoma. Melanoma. Causes, symptoms, signs, diagnosis and treatment of the disease Melanoma disease

Melanoma is a malignant neoplasm, one of the most aggressive forms of skin cancer. The trouble is that the human immune system practically does not react to melanoma and does not try to fight it, so it can quickly progress and metastasize.

Cancer is the result of abnormal and uncontrolled reproduction of "crazy" cells. In the case of melanoma, the trouble happens to melanocyte cells that produce the pigment melanin, which is responsible for tanning, freckles, age spots, eye and hair color. These cells are located:

in the skin - in the epidermis and on the border with the dermis;

in mucous membranes (epithelium).

Melanoma is often referred to as a "reborn mole". Indeed, most often it develops from an already existing mole, or, scientifically, a nevus. That is why nevi must be shown annually to a dermatologist to determine their condition.

According to tradition, in May, at the initiative of the La Roche-Posay brand, Melanoma Day is held. Many clinics invite everyone to a free examination in order to timely detect moles that require special control.

“Melanoma can even occur in the mouth and on the back of the eyeball. She especially likes areas that are often exposed to the sun, as well as those where it is difficult to notice: between the fingers, on the scalp, in the folds of the skin. Doctors note that in recent decades, the number of cases of melanoma on the legs in men has increased dramatically, this is explained by the fashion for Bermuda shorts.

Risk factors

Melanoma has many risk factors.

1
Exposure to the sun without sun protection or with insufficient protection.
2
Passion for solarium and sunbathing.
3
Light skin (I-II phototypes). This does not mean that representatives of other phototypes are guaranteed to be immune from melanoma. But pale skin is less protected from ultraviolet radiation.
4
The abundance of moles, as well as the presence of dark and prominent moles. It is believed that if there are more than 50 moles in general, this is already an additional risk factor. According to the Petrov Research Institute of Oncology, 70% of potentially dangerous nevi are congenital, and 30% are acquired.
5
Experienced (even in early childhood) sunburn.
6
genetic predisposition. According to scientists, the main role is played by the “weak link” in the immune system, which makes it difficult to resist a malignant neoplasm.
7
Age 50+. The average age of people diagnosed with melanoma is 57 years.

There is an opinion among dermatologists that at the entrance to the solarium there should be a sign: "You enter here for skin cancer." © Getty Images

Varieties of melanoma

Superficial spreading melanoma

It accounts for about 70% of all cases. This form is somewhat more common in women aged 30 to 50 years. A suspicious mole, slightly protruding above the skin, begins to increase in size and gradually turns into a granular spot (and then a spot) with jagged edges and a non-uniform color - from brown to black.

As the name implies, at first this form of melanoma grows in breadth for a long time. And only at the second stage does it move to a more dangerous growth in depth. Therefore, it is important to monitor moles.

nodular melanoma

This is the so-called nodular melanoma. It accounts for about 15% of all cases and most often affects men. This form is considered the most unfavorable, since the malignant formation quickly begins to grow deep into the skin, which accelerates the formation of metastases. Appears as a red-brown or black nodular bump on the surface of the skin. Hence the name.

Pigment-free

Pigmentless, or achromatic, melanoma develops quite rarely, literally in 1-2% of cases. However, it is especially insidious precisely because it is simply not visible. As well as nodular, it is a small nodular, rough to the touch seal on the skin, but it may not be colored in any way, which does not prevent the tumor from progressing.

Lentigo melanoma (lentiginous)

This form accounts for about 5% of cases and usually develops after the age of 55, begins with a light flat small spot, which quickly increases in size and turns out to be not just a pigment spot, but melanoma. This shape is also called "Hutchinson's freckle". It is more common in women and mostly on the face. So watch out for pigmentation!

Acral lentiginous melanoma

Spindle cell melanoma

A rare form that usually develops (but not always) in childhood and adolescence. It got its name from the elongated shape of the cells that form the formation. It is a small raised bump, pinkish or flesh-colored, smooth or rough to the touch, which is rather difficult to mistake for a malignant tumor. This type of melanoma does not cause any painful sensations, it only grows - this is the main alarm sign.

The first symptoms and signs of melanoma

How to determine the initial stage

“The ABCDE method is intended for self-diagnosis of skin growths (but does not replace regular visits to the doctor for monitoring of moles).

A-ASYMMETRY (asymmetry). A benign mole is always symmetrical. If the mole is not symmetrical, there is a risk of developing melanoma.

B - BORDERS (borders). A benign mole has even, clear boundaries. In melanoma, the borders are usually uneven, like a blob.

C - COLOR (color). A mole in which several colors are present at once (different shades of brown, black) is an alarm signal. Melanoma can also become red, white, or blue.

D - DIAMETER (diameter). The diameter of the mole has become larger than the eraser on a pencil (6 mm). Benign moles are usually (but not always!), smaller.

E - EVOLUTION (change). Any change in size, shape, color, bleeding, itching, soreness is a warning sign. You need to see a doctor immediately."

At the initial stage of melanoma, all degenerated cells are located within the surface layer of the skin - the epidermis, so it is easier to get rid of it.

Moles, at least voluminous, must be shown to a dermatologist every year. © Getty Images

A dermatoscope is sufficient for the initial examination, but the final diagnosis of melanoma can only be made on the basis of a histological examination of a distant formation (nevus).

Now there are even mobile applications that help assess the condition of the mole. But an urgent request, or rather a requirement: do not get carried away with self-diagnosis. Only a doctor can competently analyze the symptoms and signs of melanoma.

At the second stage of melanoma, the mole continues to transform, it can hurt, bleed, itch. The tumor grows already up to 4 mm deep, penetrates into the dermis, while remaining outwardly within the same boundaries as before. But there are no metastases yet, since the malignant formation has not yet reached the lymph nodes and large blood vessels.

Unfortunately, without regular check-ups, melanoma can go unnoticed and progress.

How to deal with melanoma

If a diagnosis is made or even there is only a suspicion that the nevus is malignant, most often a decision is made to perform a surgical operation - the complete removal of the formation with the capture of part of the intact nearby tissues.

At-risk groups

Summing up the above, we recall that the risk group includes the following categories:

lovers of sunbathing;

fair-skinned people;

people with a large number of moles and severe pigmentation;

people over 50;

people with a family history of melanoma.

Not a single sunburn, even received in childhood, does not pass without a trace on the skin. Protect the children! © Getty Images

Which doctor should be consulted

A dermatologist, like a therapist, should be contacted at least once a year for a general examination and consultation, without waiting for alarming symptoms.

A dermatologist using a dermatoscope will examine the skin, moles, evaluate their condition and activity. Quite often, the doctor leaves himself a “memory photo” so that at the next visit you can assess the condition and development of a particular nevus.

Overview of funds

Despite the extreme seriousness of a disease such as melanoma, there is a simple way to prevent it. Scientists from the University of Oslo conducted a large-scale study and found that even the use of a cream with SPF 15 already reduces the risk of developing melanoma by 33%. For our pale skin that has not been spoiled by the sun, products with an SPF of at least 30 are needed, and if the skin is especially fair, as well as in the presence of moles and age spots, choose SPF 50. The choice is huge.

Sun protection moisturizing dry face spray "Expert protection", SPF 50 protects the skin from both types of rays (A and B), moisturizes. easy to use - can be applied directly to the face.

Sunscreen "Expert Protection", SPF 50+, Garnier suitable for face and body, contains vitamin E and a complex of chemical sunscreens that protect the skin from broad spectrum rays.

Sun milk Sublime Sun "Extra Protection", SPF 50+, L'Oréal Paris Enriched with antioxidants that neutralize the threat of UV damage to the skin.

Sun stick for sensitive areas of the skin and lips Capital Idéal Soleil, SPF 50+, Vichy , convenient to keep handy wherever you walk in sunny time. With it, it is easy to protect the nose, cheekbones, ears and parting area, which quickly burn.

Anthelios XL Compact Facial Sunscreen, SPF 50+, La Roche-Posay allows you to quickly renew your sun protection. Protects from broad spectrum rays. Designed also for sensitive skin.

Melting Moisturizing Sun Milk Lait Solaire, SPF 50, Biotherm Suitable for both face and body. In addition to an effective sunscreen complex, it contains the antioxidant tocopherol, which helps to cope with the damaging effects of ultraviolet radiation.

Sun lotion for face and body Activated Sun Protector for Face and Body, SPF 50, Kiehl's retains moisture in the skin, contains antioxidant vitamin E and soybean oil.

Makeup base Maestro UV, SPF 50, Giorgio Armani represents complete sunscreen. Just keep in mind that UV protection is recommended to be renewed every 2 hours - the base is suitable for morning makeup if the main part of the day is still spent indoors.

does not allow sand to stick to the skin and does not cause discomfort. Spray will be effective regardless of the position of the vial.

Not so long ago, such a disease as melanoma of the skin was quite rare. At the moment, it is diagnosed annually in 4-6 people per 100,000 of the population, and every year the number of people exposed to the disease increases by 5%. This disease is rightfully considered one of the most dangerous.

Melanoma is a type of malignant neoplasm on the skin. It appears from melanocyte cells that produce the pigment melanin. Unpredictability and aggressive course is what makes melanoma dangerous. The tumor develops most often on the surface of the skin, but can occur on the mucous membranes of the mouth, throat, ocular structures, nasal cavities, and female genital organs. The disease affects both young and old people.

A neoplasm can develop on clean, unaltered skin or on the site of an existing mole. It is extremely difficult to notice a melanoma formed at the site of a mole, people do not attach much importance to a nevus that changes its shape, color and texture. And as a result, the diagnosis of a tumor occurs at a stage when treatment can no longer bring great success. On average, in just a year, the neoplasm metastasizes to the lymphatic system, and from there they spread to the internal organs: lungs, liver, kidneys, stomach, brain and inert system. You can understand what causes skin melanoma by reading this article.

Melanoma is a malignant tumor of the skin

Many people who are faced with this disease are interested in the question of how melanoma appears. Melanoma occurs when melanocytes develop. This happens due to a “breakage” in the DNA of a pigmented cell, as a result, it degenerates into a cancerous one. Anyone can develop the disease, but there is a risk group that certain people fall into.

There are a number of endogenous and exogenous causes that can affect the occurrence of melanoma. However, the presence of even a few aggravating factors in people does not mean that they will develop this oncological disease.

Factors that cause melanoma

Gender identity. According to statistics, women are more likely to suffer from the disease, but men endure it harder, this is due to the fact that male hormones contribute to the rapid development of cancer cells.
Problems with the immune system. A strong immune system can recognize even the slightest changes in DNA molecules, but disturbances in immune function can lead to changes. The disease is more common in people with congenital and acquired immunodeficiency.
The presence of benign moles. A large number of moles and birthmarks can also cause melanoma. A significant number of melanocytes are concentrated in nevi, and a mutation of even one cell can lead to melanoma.

The rebirth of an ordinary mole can occur due to the following reasons:

prolonged exposure to ultraviolet radiation on the skin;
regular injury, for example, about clothes;
gross damage - for example, injury with a razor.

The influence of age

Older people are more likely to get melanoma than younger people due to long-term exposure to harmful factors. These include:

taking medications;
exposure to ultraviolet rays;
smoking;
harmful effects of radioactive substances.

Influence of food

The appearance of melanoma is more often observed in people whose diet is dominated by high-calorie, fatty foods. Metabolic processes are disturbed in the body - this contributes to mutations in DNA. Also, people whose weight exceeds 80 kilograms more often become patients of an oncological hospital, but how exactly this affects the occurrence of a neoplasm is still not known. But contrary to popular belief, the frequent use of drinks containing caffeine, the development of melanoma has no effect.

In 70 percent of cases, melanoma arises from nevi.

Influence of ultraviolet radiation

Sunlight and solarium are the most common causes of skin melanoma. The appearance of oncology is promoted by intense and prolonged radiation. There is a frequent incidence of people living in a hot, sunny climate, as well as people with fair skin, eyes and hair, because melanocytes in their epidermis do not produce the required amount of melanin, from which the skin suffers more when exposed to sunlight. Sunburns received even in childhood and adolescence can also lead to melanoma over time.

Influence of heredity

The chances of developing the disease increase if there is a family history of melanoma. Neoplasm in relatives in a straight line increases the risk of its development by 50%. In 10% of patients, there was a relative suffering from this disease.

Melanoma of the skin is a malignant tumor, which in turn develops from pigment cells (melanocytes). These cells produce pigment, which is responsible for the color of the epidermis, hair and eyes. In this article, we will analyze in detail what skin melanoma is and find out its types and symptoms, as well as find out how to properly treat such a dangerous disease.

general information

According to statistics, it has been noted that the disease occurs in more than 200,000 cases per year. If treatment is not started on time, approximately 65,000 people die from this disease.

In Russia, melanoma accounts for 4% of all skin cancer diseases.

According to the ICD code 10: malignant melanoma of the skin is designated as C43.

Stages and types of the disease

In medical practice, there is a definition of staging of skin melanoma. It is very difficult for a person without medical education to understand the classification of the disease, but we will try to tell you about the stages in a simpler language.

Stages of melanoma of the skin:

According to Clark, when the tumor penetrates the layers of the epidermis.
According to Breslow, in this case, the thickness of the formation changes.

In the presented picture, you can see that the Clarke classification consists of 5 degrees, each of which has its own characteristics in the clinical picture.

The prognosis for skin melanoma according to the second classification is difficult. The fact is that according to Breslow there are only 4 stages. But if you look closely at the picture, you can see that according to Breslow there are two currents with stage I and stage II, it all depends on the thickness of the primary melanoma.

Types of disease

In medical practice, there are 2 forms. The first radical growth means that the malignant tumor grows above the epidermis. The second form is called vertical growth, in which case the formation grows deeper into the layers of the skin.

The main types of the disease:

Superficially spreading, most often occurs in women. Note that metastases occur in approximately 75%, so the prognosis is disappointing.
nodular melanoma. A malignant tumor spreads rapidly, with untimely treatment, a fatal outcome is observed.
Lentigious form, also called Hutchinson's freckle. The main cause of the occurrence is Dubrey's melanosis, which means senile spots. Hutchinson's freckles can occur on the background of moles or a birthmark, but this phenomenon is extremely rare.
Acral lentiginous, occurs predominantly in people with dark skin.
The unpigmented form is extremely rare.

As you can see, there are many types of the disease, each has its own causes and clinical picture.

Causes

The main cause of occurrence is a defect in the DNA molecule directly in the pigment cell. It must be understood that such cells provide not only storage, but also the transmission of genetic information. It can be concluded that under the influence of various factors, a “breakdown” occurs in the melanocyte, thereby modifying and causing the disease. All forms of melanoma of the skin and their prognosis of life depends on the factor of occurrence.

Main Risk Factors

Most often, the disease occurs with prolonged exposure to ultraviolet rays. Therefore, people should not stay in such rooms for a long time.

Important! Sunburns, which in turn were transferred in childhood, can also be attributed to the ultraviolet factor. Against the background of a burn, melanoma can also occur.

The second risk factor is quite common - the genetically white color of the skin. Many will ask why these people develop melanoma? It's simple, the white color of the skin indicates a lack of melanin synthesis. Therefore, the disease can occur with I-II skin phototype, for example: fair skin, eyes, the presence of freckles on the epidermis.

Additional reasons:

Skin cancer and melanoma occurs in Parkinson's disease. Men are prone to the disease, according to the theory, the relationship is primarily due to a common genetic predisposition.
Age . At a young age, melanoma of the epidermis is rare, it occurs more often in old age, since external and internal factors influence the skin throughout life. For example: exposure to ultraviolet rays, long-term medication, smoking.
Sexual predisposition. Androgens stimulate the growth of malignant tumors, so melanoma occurs more often in males. But, women can also develop a disease, the main reason is the long-term use of hormonal drugs.
Immunodeficiencies. If the function of the immune system is reduced, it cannot recognize and destroy altered DNA cells.
Benign lesions on the skin or precancerous lesions.

In addition to these causes, melanoma can occur when eating large amounts of animal fat and protein.

Symptoms

Symptoms of skin melanoma depend on the extent of the lesion and the type of disease. The first signs of the disease are the occurrence of itching, burning, hair falls out from the surface of the nevus.

In a patient with melanoma, the color on the pigmented formation changes, it acquires a darker color. In some cases, enlightenment occurs - already a difficult stage, which means that the cell is unable to produce melanin.

Additional signs:

Increasing the size of education.
Ulcers appear on pigmentary melanoma of the skin.
Bleeding.
The appearance of "daughter" moles.
Condensation of the mole and uneven edge.
If the pattern on the epidermis disappears in a patient (back skin melanoma is an exception), it means that the tumor has destroyed normal skin cells.
Redness around the malignancy.

If any of the above symptoms occur, you should immediately consult a doctor.

Diagnostic measures

The first step is to inspect the affected area. The doctor at the initial examination evaluates according to such criteria.

asymmetry, asymmetry is observed;
borders: the malignant formation has an irregular shape, most often toothy;
color: from light to dark tone;
diameter: education more than 6 mm.

Melanoma of the skin, general diagnosis includes not only the initial examination. In order to identify the type of disease, you must go through one of the following procedures.

Dermatoscopy is prescribed, using a special tool called a dermatoscope, a solution is applied to the damaged area. Thanks to this solution, the stratum corneum becomes transparent, so it can be well examined.

Often, CLSM is prescribed for melanoma. There is equipment in the office, with the help of which an image of the layers of the skin is obtained. This diagnosis is assigned at an early stage of the development of the disease.

For a biopsy, it is necessary to take material for research (affected epidermis). A biopsy is prescribed if a large tissue defect is formed.

Note that there are several types of biopsy: excisional, incisional and fine needle. The first type is performed with small formations, the diameter of which does not exceed 2 cm. Incisional biopsy involves marginal excision.

In rare cases, they resort to a fine-needle biopsy, the second name is puncture. It is prescribed for suspected recurrence or when metastases are detected.

Laboratory methods of examination are mandatory.

For example:

Blood test for lactate dehydrogenase.
CD44std (melanoma marker) is carried out.
Blood test for protein S100, fibroblasts.

If all the above methods do not allow an accurate diagnosis, an ultrasound examination, CT scan, angiography are prescribed.

Treatment

Treatment of skin melanoma should be comprehensive.

Medical methods include:

Chemotherapy.
hormone therapy.
Immunotherapy.

Ankylosing, vinca alkaloid preparations are used as chemotherapy. For example: Vincristine or Cisplastin, read the instructions before use.

Immunotherapy well helps to fight tumor cells, treatment is carried out with the drug Bleomycin.

In order to prevent disability in skin melanoma, doctors resort to operations. The main goal of surgery is to remove a malignant tumor, thereby preventing the spread of metastases. The operation is performed under general anesthesia.

Folk methods to strengthen the body

Treatment with folk remedies can be used with a mild course of the disease. As an immunomodulatory agent, you can prepare ginseng or an infusion of radiola rosea. It is necessary to take a solution or decoction of 20 drops per day.

If the patient was removed, then after the operation it is better to take leuzea extract. Take 25-30 drops per day. Course of treatment: a month.

Schisandra or eleutherococcus helps well with such a disease. Such plants are natural adaptogenic, therefore they have a good anti-cancer effect. Take in the dosage strictly prescribed by your doctor.

Many people ask if melanoma can be treated with compresses? In fact, compresses from medicinal plants can be used in treatment. However, not as the main medicine, but in complex therapy.

At home, you can make a compress from grated burdock root. For cooking you will need:

burdock root;
ointment based on catharanthus rosea.

Preparation: grind the burdock root and mix with the ointment in a ratio of 1:1.

Application: apply to the affected areas, no more than once a day.

Birch has a good anti-cancer agent, because it contains bitulinic acids. At home, prepare a tincture of birch buds. For 500 ml of vodka, 100 grams of raw materials will be required.

The prepared tincture should be wiped with the affected skin 2 times a day.

Without prior consultation with a doctor, alternative methods of treatment should not be used, otherwise serious health complications may occur.

Food

Do not forget about proper nutrition, because this is the key to a quick recovery.

Proper nutrition for skin melanoma:

The diet will include spices, for example: saffron, rosemary or kamun.
Fish: salmon, tuna or mackerel.
Foods high in monounsaturated fats: soybeans, corn oil, olives.
Fruit.
Natural, low-fat dairy products.
Laminaria.
Greens: green onions, seaweed, sorrel.

The diet for skin melanoma is strict, the patient must be excluded from his diet: fatty foods, mayonnaise, fast food, milk chocolate, fried foods and pastries.

At the time of treatment, limit the use of foods high in omega-6, offal and animal fats.

Preventive actions

In order to prevent the occurrence or progression of the disease, it is necessary to adhere to the rules described below.

Do not stay under UV radiation for a long time.
Use sunscreen.
If a nevus occurs on the skin, it is necessary to observe it and, if possible, remove it in a timely manner.
If you do not know if there were similar diseases in the family, seek genetic counseling and get tested.
Do not sunbathe in the solarium.
Constantly strengthen the immune system, take vitamin D.
Monitor the condition of the skin, especially when leaving the water.
Lead a healthy lifestyle.

Agree that there are few rules, the main thing is to stick to them. Remember, if you have the first signs of the disease, you need to see a doctor as soon as possible, because melanoma is a fairly serious disease that can be fatal.

To begin with, let's define the concepts of blood leukemia and melanoma cancer, and also define the fundamental differences between these diseases.
So, blood leukemia and melanoma cancer are oncological diseases. Both are called cancer, but differ in the type of organ or area of skin that is affected. Blood leukemia is a blood cancer, it is also called anemia or leukemia, because many immature blood cells, leukocytes, appear in the blood. And melanoma cancer is the same cancer, but it does not affect the blood, but the skin.

Blood cancer

Let's take a closer look at blood cancer. Oddly enough, but the geographical location of the patient and belonging to certain races affect the occurrence of the disease. Hereditary characteristics and the age of the patient also affect, children aged 3-4 years and adults over 50 are more likely to be affected. The course of the disease is more complicated and its treatment takes place in adults.
The symptoms of this disease include fatigue, reduced immunity, pain in the limbs, complex bleeding, lack of appetite, and others. But still, to determine this disease, it is necessary to conduct a series of examinations and analyzes.
When the disease occurs, the bone marrow is affected and therefore the degree of this disease is not determined. Often, the disease is not detected in the early stages.
To monitor the patient's condition and determine the disease itself with blood cancer, they take a regular blood test, a biochemical blood test and a bone marrow test, for this they take a puncture.
If, however, the disease is detected, then it will remind of itself for the rest of your life. You will either have to be treated for life, or, with a favorable outcome, be observed to prevent relapses.
Treatment is determined by the attending physician, who takes into account the stage of development of the disease and the patient's condition, which is assessed by the results of the tests.

melanoma cancer

Not every skin cancer is called melanoma. Melanoma is a malignant tumor on the skin. It affects both skin areas and internal organs.
The cause of this pigmentary disease has not yet been determined, but it is known for sure that people with fair skin, hair and eyes are more likely to be affected. And in black races, this disease occurs extremely rarely, and it is more difficult to diagnose it. People who have ever had professional burns with chemicals or metals are also susceptible to this disease.
Melanomas are different, they differ in shape, color, size, surface type. The largest melanomas reach approximately 3 mm. Very often, melanomas are extremely difficult to identify, as they are first considered to be benign age spots.
Surgery, radiation therapy, and chemotherapy are mainly used to treat this disease. Melanoma vaccines have also been invented, but their effectiveness has not been confirmed and is an experimental method of treatment.
But at the same time, a favorable outcome is not guaranteed, since the disease can kill a person in a matter of days due to the impossibility of predicting the course of the disease. The disease can have a calm course, or it can behave very aggressively and treatment can be useless and all efforts are in vain.
It is not recommended to self-medicate and turn to traditional medicine for a disease, because some herbs can create the opposite effect. Constant supervision by a doctor is necessary.
To prevent this disease, a less frequent exposure to the open sun is recommended.

In recent decades, there has been a steady increase in the incidence of melanoma. Diseases people of all ages are affected, starting with adolescence, but in people over 70 years of age, symptoms of melanoma are diagnosed more often. It is noteworthy that melanoma accounts for only 4% of all skin malignant neoplasms, but in 70% of cases the disease ends in death.

According to statistics, 10 cases per 1000 inhabitants are recorded in Europe, while in Australia the figure is much higher and amounts to 37-45 cases.

Melanoma can develop as an independent formation, but in 70% of episodes the background is a pigment spot. Nevi (moles) consist of melanocytes that synthesize the pigment melanin. Most often they have a dark color, but unpigmented nevi are also found. Sometimes they are found on the membrane of the eye, brain, nasal mucosa, in the oral cavity, in the vagina and in the rectum.

More dangerous are acquired moles that have formed already in adulthood. In 86% of patients, the development of the disease was provoked by the influence of ultraviolet radiation received in the sun or in solariums.

Melanoma cells do not have close ties with each other, so they easily break away from the total mass and migrate, forming metastases. At this stage, the disease is no longer treatable.

THE REASONS

The reason for the formation of melanoma is the degeneration of melanocytes into malignant cells. The main theory that explains this process is the molecular genetic one. Defects appear in the DNA molecule of the pigment cell. Further, under the influence of provoking factors a gene mutation occurs, associated with a change in the number of genes, violation of the integrity of chromosomes or their rearrangement. Altered cells acquire the ability to divide indefinitely, as a result of which the tumor increases in size and metastasizes. These violations can occur under the influence of adverse factors of internal and external properties, or their combination.

Causes and risk factors:

The spectrum of affected individuals is not limited to people with a low degree of pigmentation. Cases of melanoma are recorded in both fair-skinned and dark-skinned people. The risk of its development among Europeans is about 0.5%, Africans - 0.1%, while among the Caucasian peoples - 2%.

CLASSIFICATION

The disease varies in form.

Clinical forms of the disease:

Superficially spreading, or superficial. It is observed in 70% of patients, more often in women. Such melanoma is characterized by a long period of benign growth. In the deeper layers, it germinates after a long time, has a favorable prognosis.
Nodal (nodular). Invasive variant of the tumor. It quickly grows deep into the skin, looks like a convex rounded bump. The pigmentation of such a formation is usually black, less often than other dark shades, or not changed at all. Often, nodular melanoma is detected in elderly people on the limbs and trunk.
acrolentiginous. It develops on the surface of the skin, later grows deeper. A distinctive feature is the localization of symptoms - the tumor occurs on the palms, feet or under the nails. This melanoma is more common in blacks and Asians.
Lentiginous, or malignant lentigo. The neoplasm in appearance resembles a large flat birthmark. In the epithelial layer, nests of melanocytes are formed, from where they penetrate inside. It is more common in older women over 70 on the face, neck and back of the limbs.
Pigmentless (achromatic). It occurs quite rarely, in 5% of cases. Altered pigment cells lose their ability to synthesize pigment, so these formations are pink or flesh-colored. A pigmentless tumor is considered as one of the varieties of the nodular form or is considered a manifestation of metastases on the skin.

SYMPTOMS OF MELANOMA

At the beginning of the development of the disease, it is difficult to visually trace any differences between a nevus and a malignant formation. But the symptoms of melanoma appear not only on moles, the disease can develop on healthy skin. In women, symptoms often appear on the chest and legs, in men - on the arms, chest, back.

Melanoma has a number of characteristic symptoms that doctors use to diagnose the disease. The main symptom of the pathological process is changing the shape, size, color of an existing nevus.

It should also be noted that moles with signs of hair growth never become malignant.

Symptoms in the early stages of development:

asymmetry of education;
heterogeneous staining (darkening or lightening);
diameter more than 5 mm;
the edges of the formation are uneven or fuzzy;
change in the height of the spots (previously flat, they begin to rise above the surface);
change in the density of the birthmark (it becomes soft);
discharge in the area of growth;
bleeding, burning, the formation of a crust on the surface of the formation.

Symptoms in the later stages of development:

the appearance of pigmentation around the nevus;
violation of the integrity of education;
bleeding from a nevus;
sensations of itching and pain in the area of tissue damage.

The malignant form of the disease is able to actively metastasize.

Symptoms of metastatic melanoma:

continuous headaches;
the appearance of subcutaneous seals;
gray color of the skin;
the appearance of chronic cough;
enlarged lymph nodes;
convulsions;
sudden weight loss for no apparent reason.

The patient's condition is determined by the stage of the disease.

Development stages:

I stage. Spot 1 mm thick with signs of violation of the integrity of the surface or undamaged 2 mm thick;
II stage. Formation 2 mm thick with a damaged surface or 2 to 4 mm thick with an intact surface;
III stage. The surface of the tumor can be damaged or intact, there are foci of the spread of the pathological process to nearby tissues and lymph nodes.
IV stage. Tumor cells spread to distant organs. The prognosis of the disease at this stage is unfavorable, the effectiveness of treatment is rather low and amounts to only 10%.

DIAGNOSTICS

Even for an experienced doctor, diagnosing melanoma is a challenge. Of great preventive importance in this matter is the early detection of signs of the disease. An important role is played by the coverage of the problem of melanoma among the population for self-diagnosis. If any suspicious neoplasm appears on the skin or changes from birthmarks and age spots, it is necessary consult a dermatologist immediately or an oncologist.

Diagnostic steps:

Visual examination of the patient's skin and detection of pathological changes using a dermascope or a magnifying glass.
General clinical blood and urine tests.
Excisional biopsy to remove a tissue sample from the tumor (complete removal of the tumor).
Incisional biopsy of a tumor site for tissue sampling for histological analysis.
Cytological analysis of a puncture of an enlarged regional lymph node.
Chest x-ray, isotropic CT scan, MRI, ultrasound to detect lesions of internal organs.
Confocal microscopy - infrared irradiation of a layer of skin to determine the depth of melanoma germination.

TREATMENT

Any changes that occur with the nevus (change in color, shape, bleeding) require immediate surgical intervention. Doctors prefer to remove suspicious neoplasms without waiting for their degeneration.

The tumor is excised in several ways:

knife;
laser;
radio wave.

In the case of a metastatic formation, the focus is removed by combining the surgical method, immunotherapy and chemotherapy. Treatment of melanoma at different stages has its own characteristics.

Treatment depending on the stage of development of the disease:

I stage. Surgical excision is performed with the capture of healthy tissue. The area of intervention depends on the depth of germination of the formation.
II stage. In addition to excision of the formation, a biopsy of regional lymph nodes is performed. If during the analysis of the sample a malignant process is confirmed, then the entire group of lymph nodes in this area is removed. Additionally, for the purpose of prevention, alpha-interferons can be prescribed.
Stage III. In addition to the tumor, all lymph nodes that are located nearby are excised. If there are several melanomas, all of them must be removed. Radiation therapy is performed in the affected area, immunotherapy and chemotherapy are also prescribed.
IV stage. At this stage, a complete cure is no longer possible. Only those formations that cause inconvenience, as well as large neoplasms, are subject to removal. Sometimes it is possible to remove metastases from the internal organs, some patients are recommended a course of chemotherapy and radiation treatment.

COMPLICATIONS

The main complication of melanoma is the spread of the pathological process with the help of metastases.

Postoperative complications include appearance of signs of infection, changes in the postoperative incision (edema, bleeding, discharge) and pain. At the site of the removed melanoma or on healthy skin, a new mole may develop or discoloration of the integument may occur.

PREVENTION

Preventive measures involve the early removal of any traumatized formations in specialized medical institutions.

Prolonged exposure to the sun is contraindicated. You need to get used to the influence of sunlight gradually, using sunscreen. It is very important to protect children from sunburn. It is necessary to protect not only the skin, but also the eyes with the help of dark glasses with special filters. It is also better to refuse tanning in the solarium.

PROGNOSIS FOR RECOVERY

The prognosis for melanoma depends on the degree of development of the tumor and the time of its detection. In the early stages the disease responds well to treatment. The survival of patients for five years after treatment of stages I and II is 85%, while stage III with signs of metastasis gives a chance for life to half of the patients.

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