Melanoma case
Introduction
A 45-year-old Caucasian female presented with a rapidly changing "black mole" on her left leg. Initially it was a flat brownish macule, which she had for many years. The patient reported that the lesion had become slightly raised with irregular borders over a period of 4 weeks prior to her presentation (see Figure 1). Upon questioning, the patient stated that she had received approximately 20 sessions of UV exposures per year for 5 consecutive years at tanning salons. She also mentioned that she was not compliant with the use of sunscreen while working outside or at the beach. There were no personal or family histories of malignant melanoma. Skin examination showed an 8 mm × 10 mm irregularly shaped two-toned brown papule with ill-defined light brown to pink medial and lower borders, and a dark-brown central area localized to the calf of the left leg. There was no lymphadenopathy. The remainder of the physical examination and review of systems were unremarkable. Fig. 1 A brown two tone lesion present on the posterior surface of the right leg
[ CLOSE WINDOW ]
Figure 1.
A two-toned brown papule on the left calf
Epidemiology and Risk Factors
Malignant melanoma is the fastest-growing and 7th most frequent cancer in the United States. Its incidence has tripled among Caucasians over the last 40 years with an expected incidence of 1 in 50 by the year 2010, but only about one-quarter of cutaneous melanomas are discovered directly by physicians .
Established risk factors for malignant melanoma include the following :
Intense intermittent sunlight exposure (primarily UVB) and blistering sunburns at an early age.
Skin types with phototype I and II being more prone to developing malignant melanomas.
Personal history of melanoma.
Family history of melanoma.
Multiple nevi. (Of note, the vast majority of malignant melanomas arise de novo.)
Immunosuppression
Diagnosis
The Alphabet of Melanoma: ABCD Plus E & F. The ABCD rule may potentially
A 45-year-old Caucasian female presented with a rapidly changing "black mole" on her left leg. Initially it was a flat brownish macule, which she had for many years. The patient reported that the lesion had become slightly raised with irregular borders over a period of 4 weeks prior to her presentation (see Figure 1). Upon questioning, the patient stated that she had received approximately 20 sessions of UV exposures per year for 5 consecutive years at tanning salons. She also mentioned that she was not compliant with the use of sunscreen while working outside or at the beach. There were no personal or family histories of malignant melanoma. Skin examination showed an 8 mm × 10 mm irregularly shaped two-toned brown papule with ill-defined light brown to pink medial and lower borders, and a dark-brown central area localized to the calf of the left leg. There was no lymphadenopathy. The remainder of the physical examination and review of systems were unremarkable. Fig. 1 A brown two tone lesion present on the posterior surface of the right leg
[ CLOSE WINDOW ]
Figure 1.
A two-toned brown papule on the left calf
Epidemiology and Risk Factors
Malignant melanoma is the fastest-growing and 7th most frequent cancer in the United States. Its incidence has tripled among Caucasians over the last 40 years with an expected incidence of 1 in 50 by the year 2010, but only about one-quarter of cutaneous melanomas are discovered directly by physicians .
Established risk factors for malignant melanoma include the following :
Intense intermittent sunlight exposure (primarily UVB) and blistering sunburns at an early age.
Skin types with phototype I and II being more prone to developing malignant melanomas.
Personal history of melanoma.
Family history of melanoma.
Multiple nevi. (Of note, the vast majority of malignant melanomas arise de novo.)
Immunosuppression
Diagnosis
The Alphabet of Melanoma: ABCD Plus E & F. The ABCD rule may potentially