Melanoma

Background

• Ultraviolet UVB light (315 – 280 nm) from sun/tanning beds damages DNA
• High risk in fair skin, blue eyes, and red-haired people,
• High risk hx of multiple atypical nevi or dysplastic nevi

Clinical Features

• Asymmetry
• Borders (irregular)
• Color (variegated)
• Diameter (greater than 6 mm (0.24 in), about the size of a pencil eraser)
• Evolving over time or Elevated above the skin

On the left side from top to bottom: melanomas showing (A) Asymmetry, (B) a border that is uneven, ragged, or notched, (C) coloring of different shades of brown, black, or tan and (D) diameter that had changed in size compared to normal moles on the right.

Differential Diagnosis

==Diagnosis==]

• Biopsy outpt at dermatology office
• LDH (elev indicates metastasis, particularly to the liver, not sensitive)
• Imaging for metastasis
  • CXR or CT
  • MRI, PET and/or PET/CT scans

Disposition

• Refer to dermatology