Transcript Melanoma




Intermittent high exposure to the sun is a major
risk
Other risk include a family history and an
increased number of nevi
Familial atypical multiple mole syndrome
(FAMM) caused by mutation of p16 gene
3.6.2017
Mark Browning, M.D.
IUSME







Sun Exposure & Indoor Tanning
Many Moles, Fair Skin, & Family History
Inherited conditions, Familial Melanoma
Previous History of Skin Cancer
Race White’s 24X > Blacks
Average age is 50 …but increases with Age
Immunosuppression


Malignant nevi show variance of color, irregular
surface, irregular perimeter, bleeding and
ulceration (very bad sign)
Trunk location is worse than extremity location

Key diagnostic information:

Immunohistochemistry S-100 (+), Melan-A (+)

Depth of invasion (Breslow’s score)

Presence or absence of ulceration




Intermittent high exposure to the sun is a major
risk
Other risk include a family history, increased
number of nevi
Malignant nevi show variance of color, irregular
surface, irregular perimeter, bleeding and
ulceration (very bad sign)
Breslow's’ score and presence/absence of
ulceration are critical to know





76,000/year 47k men & 29 k women
1% of All Cancer
10,000 Deaths per year
10 year Survival Rate is 89% for all melanomas
Survival Rate Depends on the Stage

Self Examination
Front & Back With Mirror & with Arms Raised
 Front & Back of Both Legs, Palms, Soles
 Neck, Scalp with Hand Mirror
 Back, Buttocks & Genitals with Hand Mirror
 Photographs with caliber q 6 months & logged


Call Doctor for:



New Growth
Change In Mole
Sore that Doesn’t Heal




Biopsy…Diagnosis…Wide Excision
Sentinel Node Biopsy for Depth > 1mm
Adjuvant Interferon for + Lymph Node or
Depth > 4mm
Metastatic Disease
BRAF Inhibitors
 BRAF & MEK inhibitors
 KIT Inhibitors
