melanoma | Skin Cancer (Melanoma)

Skin Cancer (Melanoma)

How to detect skin cancer?
Rule ABCDE
How do you distinguish a mole from an old age spot or a starting melanoma? There is a practical mnemonic way: the ABCDE rule.

A for asymmetry: some melanomas are asymmetric.
B for edges: a mole has a smooth, regular contour. The edges of the melanomas are often irregular, jagged (jagged) or grooved.
C for color: Several different colors on a nevus can be a sign of melanoma. Most melanomas are very dark.
(D) for diameter: a mole with a diameter greater than or equal to 6 mm shall be examined.
E for Evolution: If a mole changes appearance, it is advisable to consult a doctor.
When a mole has a change in one or more of these characteristics, it may be melanoma.

Other symptoms should also alert you: itching, bleeding, forming a crust, redness.

However, this ABCDE rule is not valid for many novice melanomas and many benign nevus respond to the ABCDE rule. Although it is well known to the general public, it is questioned as unreliable. Many dermatologists nevertheless insist on the E of the rule: any nevus that changes, especially if it changes size quickly (a few weeks, a few months), if it becomes asymmetrical and/or if a second color appears, you should consult Quickly.

The "Ugly Duckling" rule
If a mole suddenly seems not to resemble others, it must be examined. It is the sign of the "Little Duck": a mole has appeared or turned and strikes eye because it is darker, lighter, redder, etc. than the others. Apply the ABCDE rule and/or the "Naughty duckling" rule
Look at your face in a mirror.
Examine the skin of the scalp with the help of someone. It's easier if the hair gets wet.
Examine your forearms, hands and feet without forgetting the palms and the plants, the spaces between the fingers and the fingernails.
Stand in front of a mirror and examine your arms, neck, chest and belly.
Stand back in the mirror, and take a hand-held mirror to check your neck, shoulders, top of your back and back of the top of your arms.
Finally, check in the mirror the lower part of your back, your buttocks, your thighs and the back of your legs UV causing skin cancer (melanoma)
Exposure to UV radiation from the sun is one of the causes demonstrated in the development of melanoma. Studies show that temporary and brutal exposure to the sun, for example during beach vacations, is a significant risk factor. Repeated sunburn, especially during childhood, also increases the risk of melanoma. An extended stay in the tropical country during childhood is in itself a risk factor for melanoma. People born in Africa are a typical example.

Prevention campaigns therefore play a particularly important role. It is essential that the public be aware of the risks of exposure to sun rays and know how to protect them.

In the case of the solar panel, it is essentially its use in the young girl and the young woman that is a risk factor for melanoma. Its use in middle-aged or elderly women facilitates keratoses actinic, squamous carcinomas, and general ageing of the skin (wrinkles, etc.).

Self-examination to detect skin cancer
Melanoma (skin cancer) should be detected as soon as possible. The longer the diagnosis is delayed, the more the tumor has time to penetrate the deeper layers of the skin and the more likely the definitive cure decreases. The peculiarity of melanoma is that it is visible. Self-examination plays an important role. When you examine your skin (or someone else's), remember the rule abcde and the "ugly duckling" rule. And do not hesitate to consult a dermatologist if you notice that one of your moles changes appearance.

Suspicious Mole: Diagnostic resection
The diagnostic resection
If the dermatologist thinks that the suspicious mole might be a melanoma, it will try directly to remove all the part of the skin where the melanoma is located. The procedure is called "diagnostic resection" because the purpose of the resection is both to remove the tumor but also, after examination, to make the diagnosis. This operation takes place under local anesthesia. Then it sends the skin fragment to the pathologist for analysis. Any destruction of a mole (suspect or not), for example by laser, is strictly forbidden because no analysis will be possible. The partial removal of the lesion, either by "decapitating" it and then burning the base ("Shave-coagulation" technique), or by performing a partial biopsy, should, as far as possible, be avoided. These techniques are sometimes, but it's rare, inevitable.

Surgical resection
If, after analysis, the pathologist diagnoses melanoma, more important safety margins around the melanoma should be provided in both breadth and depth.

Why didn't you do it from the first time, during the diagnostic resection? Before removing a mole and the skin around it, the dermatologist wants to be sure that it is really melanoma, not an atypical mole or a slightly pigmented wart. On the other hand, margins can not be guessed in advance. Finally, if the Sentinel ganglion is to be removed, the wide excision is a handicap if it was performed from the outset.

How much skin to remove?
The margins of the resection depend on the thickness of the melanoma. In situ melanoma, the margins are 0.5 cm. Beyond the in situ melanoma, the thickness is measured by the Breslow index. If the latter is less than or equal to 2 mm, 1 cm of margin is sufficient. Otherwise, the margins must be 2 cm.

Surgical resection can give rise to a fairly extensive wound, impossible to suture. To close it, the surgeon then performs a graft or flap.