MOLES, MELANOMA and SKIN CANCER
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Transcript of MOLES, MELANOMA and SKIN CANCER
MOLES, MELANOMA and SKIN CANCER
Mary C. Martini, MD, FAADAssociate Professor Dermatology
Director, Melanoma and Pigmented Lesion ClinicNorthwestern University
MOLES Everyone gets
moles They can get
bigger and darker due to sun burns and heavy sun exposure
Some families make “atypical” or irregular moles
MOLES
MOLES Benign or healthy
moles
Irregular moles-”dysplastic”
Melanoma
Dysplastic Nevus Multicolored Asymmetric
pigment deposition
Asymmetric contour-macular and papular
Indistinct margins
Atypical mole syndrome-(Dysplastic nevus
syndrome) >100 melanocytic
nevi 1 or more nevi
>8mm in diameter
1 or more dysplastic nevi on exam
Atypical Mole Syndrome has a 10 year risk of developing melanoma of 14%
Wang et al.JAAD 2005;50:15-20
Management of the Dysplastic Nevi Patient
Close monitoring- full body exams every 6 months
Dermoscopy of all atypical appearing nevi
Whole Body Photos Excision of any changing or
markedly atypical nevi
Body Mapping Studio
positioning stage indexed monostandbalanced cross-lighting
high resolution digital camera
body mapping software
The Body Map
At Home Exam
Dermoscopy The magnified visualization of pigmented skin
lesions beyond what would be visible by the physician
Increases diagnostic accuracy by 10-20%
Dermlite.com
Benign Nevireticulated pattern
Dysplastic Nevi
Asymmetric pigment pattern
Irregular depigmentation
Irregular edge
Dysplastic Nevi
Melanoma
Melanoma
Changes in Overall Cancer Mortality (1975-2000)
Prostrate -5% Breast -15% Colorectal -25% MELANOMA +28%
Melanoma
Melanoma
Tumor Thickness- Breslow level
Level 5yr survival
<0.75mm 97.9%
0.76-1.49mm 91.7%
1.5-3.99mm 72.8% >4mm 57.5% Barnhill et al,Cancer 1996
Incidence of melanoma 1900 - 1 in 2000 2004 - 1 in 70 Major cause is ultraviolet exposure
Tanning bed use before the age of 35 increases the risk
of skin cancer by 75%
SUN DAMAGE
PHOTOAGING Sun damage
Pollution
Heredity
LENTIGOS “Sunspots or big
freckles” Increase in size
and color with more sun exposure
Areas with these growths may be areas that develop skin cancer years later
Lentigo
Lentigo
Photodamage
Actinic Keratosis
SKIN CANCER Basal cell
carcinoma
Squamous cell skin cancer
Melanoma
Basal Cell Carcinoma Most common skin cancer Never metastasizes Sun damage is the major cause
Basal Cell Carcinoma
Basal Cell Carcinoma
Squamous Cell Carcinoma Second most common form of skin
cancer Can metastasize if neglected and
continues to grow Sun damage plays a major role
Squamous Cell Carcinoma Can occur in preexisting burn and
traumatic scars Can occur on lower lip due to
smoking or chewing tobacco in addition to actinic damage
Squamous Cell Carcinoma
Benign Lesions
Warts Caused by a virus Spread by shedding
skin Treated by “cryo”, 5FU or salicylic acid
plaster-oral/genital warts
linked to cervical and oral/throat cancer
WARTS
Angiomas
Seborrheic Keratosis
Dermatofibromas
Sebaceous Hyperplasia
SUNSCREENS Facial everyday sunscreens SPF 15-25: Eucerin
facial, Oil of Olay facial, Purpose
Chemical free- titanium dioxide and zinc oxide- Blue Lizard and Neutragena
Waterproof sunscreens SPF 35-70: Coppertone sport, Neutragena with helioplex, Blue lizard, in Canada or Europe sunscreens with Mexoryl
Reapply every 2 hours if swimming or sweating
Skin Cancer Prevention Skin protection involves use of
sunscreens including reapplication Wear sun screen containing
clothing and hats Avoid prolonged sun exposure
from 11 am to 3 pm