Moles and Melanoma PowerPoint Presentation

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MOLES, MELANOMA and SKIN CANCER Mary C. Martini, MD, FAAD Associate Professor Dermatology Director, Melanoma and Pigmented Lesion Clinic Northwestern University

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MOLES Everyone gets moles They can get bigger and darker due to sun burns and heavy sun exposure Some families make “atypical” or irregular moles

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MOLES

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MOLES Benign or healthy moles Irregular moles-”dysplastic” Melanoma

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Dysplastic Nevus Multicolored Asymmetric pigment deposition Asymmetric contour-macular and papular Indistinct margins

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Atypical mole syndrome-(Dysplastic nevus syndrome) >100 melanocytic nevi 1 or more nevi >8mm in diameter 1 or more dysplastic nevi on exam

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Atypical Mole Syndrome has a 10 year risk of developing melanoma of 14% Wang et al.JAAD 2005;50:15-20

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Management of the Dysplastic Nevi Patient Close monitoring- full body exams every 6 months Dermoscopy of all atypical appearing nevi Whole Body Photos Excision of any changing or markedly atypical nevi

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Body Mapping Studio positioning stage indexed monostand balanced cross-lighting high resolution digital camera body mapping software

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The Body Map

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At Home Exam

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Dermoscopy The magnified visualization of pigmented skin lesions beyond what would be visible by the physician Increases diagnostic accuracy by 10-20% Dermlite.com

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Benign Nevireticulated pattern

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Dysplastic Nevi

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Asymmetric pigment pattern Irregular depigmentation Irregular edge Dysplastic Nevi

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Melanoma

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Melanoma

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Changes in Overall Cancer Mortality (1975-2000) Prostrate -5% Breast -15% Colorectal -25% MELANOMA +28%

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Melanoma

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Melanoma

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Tumor Thickness- Breslow level Level 5yr survival <0.75mm 97.9% 0.76-1.49mm 91.7% 1.5-3.99mm 72.8% >4mm 57.5% Barnhill et al,Cancer 1996

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Incidence of melanoma 1900 - 1 in 2000 2004 - 1 in 70 Major cause is ultraviolet exposure

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Tanning bed use before the age of 35 increases the risk of skin cancer by 75%

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SUN DAMAGE

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PHOTOAGING Sun damage Pollution Heredity

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LENTIGOS “Sunspots or big freckles” Increase in size and color with more sun exposure Areas with these growths may be areas that develop skin cancer years later

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Lentigo

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Lentigo

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Photodamage

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Actinic Keratosis

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SKIN CANCER Basal cell carcinoma Squamous cell skin cancer Melanoma

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Basal Cell Carcinoma Most common skin cancer Never metastasizes Sun damage is the major cause

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Basal Cell Carcinoma

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Basal Cell Carcinoma

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Squamous Cell Carcinoma Second most common form of skin cancer Can metastasize if neglected and continues to grow Sun damage plays a major role

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Squamous Cell Carcinoma Can occur in preexisting burn and traumatic scars Can occur on lower lip due to smoking or chewing tobacco in addition to actinic damage

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Squamous Cell Carcinoma

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Benign Lesions

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Warts Caused by a virus Spread by shedding skin Treated by “cryo”, 5FU or salicylic acid plaster -oral/genital warts linked to cervical and oral/throat cancer

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WARTS

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Angiomas

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Seborrheic Keratosis

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Dermatofibromas

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Sebaceous Hyperplasia

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SUNSCREENS Facial everyday sunscreens SPF 15-25: Eucerin facial, Oil of Olay facial, Purpose Chemical free- titanium dioxide and zinc oxide- Blue Lizard and Neutragena Waterproof sunscreens SPF 35-70: Coppertone sport, Neutragena with helioplex, Blue lizard, in Canada or Europe sunscreens with Mexoryl Reapply every 2 hours if swimming or sweating

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Skin Cancer Prevention Skin protection involves use of sunscreens including reapplication Wear sun screen containing clothing and hats Avoid prolonged sun exposure from 11 am to 3 pm

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