Melanoma

Question 1

**Melanoma r/f

Answer 1

Most serious skin lesion
1. Prev h/o - x10 fold
2. >5 atypical moles - x6 fold
3. >50 moles present
4. Fam h/o
5. Blistering sun burn as child
6. Male

Question 2

Initial mx for melanoma

Answer 2

Full excision with 2mm margin

Question 3

Lentigo maligna melanoma

Answer 3

Slow growing, irregular pigmented papule
Melanoma insitu
can turn invasive

Question 4

Mc type of melanoma

Answer 4

Superficial spreading melanoma

Question 5

Name the melanoma which occurs on fingers and toes

Answer 5

Acral lentigenous melanoma

Question 6

Prognostic factors of melanoma

Answer 6

1. Depth of melanoma - Breslow thickness
   <0.75mm - good prognosis (90% chance of cure)
   =>4mm - bad (30% chance of cure)
2. Sentinel Lymph node biopsy if >0.75mm thick or high r/f+

Question 7

Mx of melanoma

Answer 7

1. Suspicious - full excision with 2mm margin (NO BIOPSY- might not contain melanocytic cells)
2. Diagnosed - re-excision with in 4wks by specialist

Question 8

**Excision margins of melanoma with respect to breslow thickness

Answer 8

Thickness:
Melanoma insitu: 0.5-1cm
<1mm: 1cm margin
1-4mm: 1-2cm margin
>4mm: 2cm or more(6monthly check ups, smaller - yearly)

Suspicious - 2mm margin