Melanoma

Question 1

What are the four types of melanoma

Answer 1

Superficial spreading
Nodular
Lentigo maligna
Acral lentiginous

Question 2

Features of superficial spreading melanoma

Answer 2

• affects Arms, legs, back and chest
• common in young people
• abnormal mole

Question 3

Features of Nodular melanoma

Answer 3

• sun exposed skin
• middle aged
• Red or black lump which bleeds or oozes

Question 4

Features of lentigo maligna melanoma

Answer 4

• Chronically sun-exposed skin
• found in older people
• abnormal mole

Question 5

Features of acral lentiginous melanoma

Answer 5

• Rare
• Affects Nails/ palms/ soles
• People with darker skin pigmentation
• appears as Subungual pigmentation (Hutchinson’s sign) or on palms or feet

Question 6

Diagnostic features for malignant melanoma

Answer 6

MAJOR:
Change in:
- size
- shape
- colour

MINOR:
- Diameter >= 7mm
- Inflammation
- Oozing or bleeding
- Altered sensation

Question 7

What is breslow thickness?

Answer 7

measurement to the deepest melanocyte
high breslow thickness = poor prognosis

Question 8

Margins for excision should be higher if a lesio has a larger breslow thickness. TRUE/FALSE?

Answer 8

TRUE
e.g. if breslow thickness >4mm, margins should be 3cm

Question 9

Describe the difference in 5 year survival between a low and high breslow thickness

Answer 9

< 0.75 mm = 95-100%
0.76 - 1.50 mm = 80-96%
1.51 - 4 mm = 60-75%
> 4 mm = 50%