Melanoma is a skin cancer that begins in the melanocytes, cells that produce moles. Healthy moles can be elevated or flat, brown or dark brown, of even shape and up to 1 cm in diameter. When a mole appears and reaches its size, it stops changing and remains the same throughout life. Dermoscopy is desirable once in 12 to 18 months. Moles with irregular shape can still be healthy, but in that case we call them atypical or dysplastic moles, and they should be followed and checked once every 6 months. This is the shortest period of time in which dysplastic mole can start changing into melanoma. The exceptions are lesions that are above the surface of the skin, similar to peas. We never follow such lesions because their cells change very quickly and sometimes a period of one month can be crucial.
Malignant melanoma
Malignant melanoma

How to recognize a melanoma?

There is an ABCDE rule in the development of melanoma, which should be a guideline for self-exam: AAsymmetry, one half is unlike the other half BBorder, irregular, scalloped, or poorly defined border CColour, varied from one area to another (shades of red, black, grey and blue) DDiameter, 6mm or larger although melanoma can sometimes be smaller than 6mm EEvolution, changing in colour, shape, or size Unfortunately, not all melanomas have these characteristics. Any change in the colour, shape or size of a mole should alert us to see a doctor. Itching, pain, blood are definitely warning signs. Persistent itching of the mole can be caused by eczema (Meyerson naevus), but it can also be a precursor to pain. If you notice the development of a new mole, and are more than 25 years old, you should check if the mole has even structure. It is almost impossible to do it without dermoscopy. Malignant melanoma rarely has the same colour as the skin, and then it looks like a small wound that will not heal. Such lesions must be sent for pathohistological analysis, even if they seem harmless.

What to do if we suspect or notice a change?

It is necessary to consult a dermatologist or a surgeon who performs dermoscopy. Dermoscope is a special device used to examine moles. Polarized light and 100x magnification allow you to see the deeper structure of the mole. With a dermoscope, it is possible to see changes in a mole two years before they can be seen with the naked eye. If a physician thinks that it is necessary to remove the mole, it should be done as soon as possible. Malignant melanoma is one of the few cancers that can be completely cured when they are in the zero phase. In the zero phase, there are atypical cells and they have the same distribution as in melanoma, but they have not entered the basal membrane zone. With complete removal, the patient is 100% cured. Delaying the intervention leads to the transition of cells towards the deeper layers of the skin and subcutaneous tissue. The only correct way to remove moles when melanoma is suspected is using surgery. When melanoma is suspected, the surgical intervention is performed in such a way as to encompass a wider and deeper area than when a healthy mole is removed.
Svetlana Đurišić specijalista dermatovenerologije

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