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“Melanocyte, Mole, Melanoma: Back to the basics ” Deba P Sarma, MD Omaha

“Melanocyte, Mole, Melanoma: Back to the basics ” Deba P Sarma, MD Omaha. Objectives: At the end of the presentation the participant should be able to:. 1. Explore the relationship between melanocytes, moles and melanoma. 2. Summarize the risk factors for melanoma.

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“Melanocyte, Mole, Melanoma: Back to the basics ” Deba P Sarma, MD Omaha

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  1. “Melanocyte, Mole, Melanoma: Back to the basics ” Deba P Sarma, MD Omaha Objectives: At the end of the presentation the participant should be able to: 1. Explore the relationship between melanocytes, moles and melanoma. 2. Summarize the risk factors for melanoma. 3. Review the preventive measures against melanoma.

  2. News Headline Melanoma cases surge among young women The incidence of the deadly skin cancer increased by 50% between 1980 and 2004, a study finds. Use of tanning salons is cited as one possible reason. Los Angeles Times. July 11, 2008

  3. On the campaign trail, few mentions of McCain’s bout with melanomaThe N Y Times March 9, 2008

  4. MelanocytesMoleMelanoma Deba P Sarma, MD Creighton University Medical Cernter, Omaha

  5. Melanocytes

  6. Melanocyte

  7. Nevus = Mole • Spot, ‘Beauty mark’

  8. Life of a nevus

  9. Congenital nevus

  10. Common nevi • Junctional • Compound • Dermal

  11. Dysplastic nevus

  12. Dysplastic nevus

  13. Melanoma • Types Melanoma in situ Melanoma (Invasive melanoma)

  14. Melanoma • Lentigo maligna melanoma • Superficial spreading melanoma • Nodular melanoma • Acral lentiginous melanoma • Desmoplastic melanoma

  15. Lentigo maligna melanoma

  16. Superficial spreading melanoma

  17. Nodular melanoma

  18. Acral lentiginous melanoma

  19. Estd new cancer cases, USA, 2008 American Cancer Society Male:Female: 1. Prostate (25%) 1. Breast (31%) 2. Lung (15%) 2. Lung (14%) 3. Colorectum (10%) 3. Colorectum (10%) 4. Bladder (7%) 4. Uterus (5%) 5. NH Lymphoma (5%) 5. NH Lymphoma (4%) 6. Melanoma (5%) 6. Thyroid (4%) 7. Kidney (4%) 7. Melanoma (4%)

  20. Estd new melanoma cases, 2008 American Cancer Society, 2008 • USA : total 116,500 ( In situ 54,000 Invasive 62,500 ) • NEBRASKA: 380 ( Invasive melanoma) Estd deaths from melanoma, 2008 • USA 8500 • NEBRASKA 50

  21. Risk factors • Uncontrollable: Skin type (race) History of melanoma Molesand atypical moles Age: 70 + Gender: M > F • Controllable: UV radiation( sunlight, tanning booths and lamps)

  22. Skin types I II III VI IV V

  23. History of melanoma • First-degree relatives: Father, mother, brother, sister, child • Personal history of melanoma • Melanoma pt.: Family history in 10%.

  24. Common acquired nevi, atypical nevi • Normal nevi Abnormal nevi • Age: 2-30New mole after 30 • Number: 20-30Number: >50 Atypical mole: >5 Familial dysplastic mole syndrome

  25. Sun

  26. Protection from UVA UVB • Seek shade, avoid outdoors: 10am to 4pm • Protective clothing • Wraparound sunglasses, broad-brimmed hats • Sunscreen, broad spectrum, at least 15 SPF • No tanning booth or sun lamp

  27. Melanoma Prevention Moles: Professional screening Self-examination New mole after 30 Changing mole

  28. Danger signsABCD

  29. CML Melanoma12 months: 3/1/07-3/1/08 • Total cases: 56 Male: 36 Female: 20 • Age: 27-95 • Male: <50: 11 >50: 29 • Female: <50: 7 >50: 13

  30. Melanoma sites

  31. Sites • Head & neck: 20 ( Male 18, Female 2) • Upper limb: 4 ( Male 2, Female 2) • Lower limb: 12 ( Male 2, Female 10) • Trunk: 20 ( Male 14, Female 6)

  32. Types • Melanoma in-situ: 20 Lentigo maligna 8, Pagetoid 12 • Superficial spreading melanoma: 23 • Lentigo maligna melanoma: 4 • Nodular melanoma: 5 • Desmoplastic melanoma: 2 • Recurrent melanoma: 2

  33. Five-year survival rate • Overall 90% • Localized 99% • With regional spread 45% • Good news: 80% localized at diagnosis

  34. Editorials 1985-2008 • Ackerman AB. No one should die of malignant melanoma. J Am Acad Dermatol. 1985 Jan; 12: 115-6. • Kittler H. Early recognition at last. Arch Dermatol. 2008 April;144: 533-4.

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