Melanoma

Melanoma arises in the melanocytes (pigment cells) in the skin. Melanocytes produce melanin (skin pigment) in the deeper layers of the skin. When these cells are damaged, for example by UV radiation from the sun or tanning beds, changes (mutations) can occur. The mutated cells multiply, allowing a tumour to damage surrounding tissue.

Melanoma can develop from existing birthmarks or other skin patches, but in most cases they arise from 'nowhere'.

How dangerous is melanoma?

Melanoma is the most aggressive form of skin cancer. When a melanoma grows superficially and does not metastasise, a melanoma is excised and the future looks bright. However, melanoma can be life-threatening at a further stage, when the tumour cells of melanoma spread to other parts of the body (such as lymph nodes and organs), it can kill you. So it is better to be careful and always be on the safe side when in doubt about a skin spot.

What does a melanoma look like?

Melanomas can look different and occur anywhere on the body. It is important to look out for the following signs: changes in size (gets bigger), shape (irregular edges), asymmetry (no symmetrical edges), height (a flat mole gets higher or thicker), itching, pain, bleeding, scabs and/or inflammation. Multiple colours can also develop within 1 spot, such as black, light brown, dark brown, blue-black, white-pink or red.

What forms of melanoma are there?

• Melanoma in situ: This means melanoma "in place" in Latin. A superficial melanoma that is only in the upper layers of the skin. There are no metastases yet.
• Lentigo maligna: Brown or brown-black spot that grows slowly and has an irregular shape. A lentigo maligna is a melanoma in situ and slowly progresses to melanoma. Not all pigment spots are malignant. You also have benign pigment spots with a more even colour, these are popularly called 'lentigo solaris' or sun spots.
• Superficial spreading melanoma: Most common type of melanoma. This kind grows superficially in the skin and continues to grow for months to years. Sometimes to the depth of the skin.
• Nodular melanoma: This variety starts under the skin and grows as a dark blue or black lump. Often manifests as a small bleeding wound or ulcer in the skin.
• Rare forms of melanoma: Acrolentigineous melanoma (acra means tip in Latin) occurs on the palms of the hands, soles of the feet and nails. There are melanomas that arise on mucous membranes and these are called mucosal melanomas. There are also amelanotic melanomas, this form has no pigmentation and are pink in colour, making them difficult to recognise.

Risk factors for melanoma

• Excessive exposure to ultraviolet radiation from the sun and tanning beds. Also frequent sunburn at a young age.
• Individuals with many common moles (more than 50) or troubled moles (more than 3).
• Light skin types, mainly skin type 1. This skin type is characterised by blond or reddish hair, freckles, difficulty to not tan and rapid sunburn.
• Hereditary predisposition. When family members have also had melanoma, the risk increases.

What is the treatment?

Usually, melanoma is surgically removed by a doctor, such as a dermatologist or oncologist. Afterwards, the spot is examined in the laboratory by a pathologist. At further stages, lymph nodes are also removed from the treated area and treatments are used to control metastases.

Example photo of melanoma