Malignant Melanoma

Question 1

What are the 4 types of melanoma?

Answer 1

• Superficial - most common
• Nodular - most aggressive
• Lentigo maligna
• Acral lentiginous

Question 2

Where does melanoma present?

Answer 2

1. Superifical: arms, back, chest and legs of older people
2. Nodular: Sun exposed skin in middle aged people
3. LM: Chronically sun-exposed skin in older people
4. AL: Nails, palms or sole of people with darker skin

Question 3

How does melanoma present?

Answer 3

Superficial: flat lesion with irregular borders
Nodular: pigmented lesion which can penetrate deep into skin
LM: irregular brown macule which grows slowly
AL: flat pigmented area which then becomes thicker and irregular

Question 4

What is the criteria used for skin lesions?

Answer 4

7 point checklist
Major (2 points)
1. Change in size
2. Irregular shape
3. Irregular colour
Minor (1 point each)
1. Largest diameter > 7mm
2. Inflammation
3. Oozing
4. Change in sensation

Question 5

How should melanoma be managed?

Answer 5

• Refer if score of 3 or more or if any concerns of nodular melanoma
• Treatment includes excision biopsy