Symptoms of Melanoma, причины, типы, стадии,diagnostics

Melanoma is a type of cancer in which a lesion occurs.
melanocytes – pigment cells located in human skin.

Melanoma has a high risk of rapid metastasis,
which leads to the development of severe complications and, in severe cases,
death of the patient. Every year in the United States registered about 50 thousand new
случаев заmoreвания меланомой.

Первым звеном в своевременной диагностике заmoreвания являются
patients themselves, since melanomas usually occur on open,
visible skin areas. it важно, так как раннее обнаружение и
diagnosing melanoma provides a quick cure with
minimal surgical intervention.

Статистика заmoreвания

Skin cancer ranks first in prevalence among
онкологических заmoreваний в США и Австралии. In other countries
данная группа заmoreваний находится в первой тройке. Melanoma –
the leader among skin forms of cancer in the number of deaths.
Каждый час в мире от данного заmoreвания погибает один человек. AT
77 thousand confirmed diagnoses were registered in 2013
�”Melanoma” and 9500 deaths from it. The proportion of melanoma in the structure
онкологических заmoreваний составляет всего 2,3%, в то же время
causing 75% of skin cancer deaths.

This form of cancer is not exclusively cutaneous and may
affect the eyes, scalp, nails, feet,
oral mucosa (regardless of gender and age). Risk
development of melanoma among representatives of the Caucasian nationalities
is 2%, 0.5% among Europeans and 0.1% among Africans.

The reasons

  • Long stay in the sun. ATоздействие
    ultraviolet radiation, including tanning, can cause
    development of melanoma. Excessive sun exposure in the nursery
    возрасте значительно повышают риск заmoreвания. Residents of the regions with
    increased solar activity (Florida, Hawaii and Australia)
    moreе подвержены развитию рака кожи.

A burn caused by prolonged exposure to the sun increases
риск развития меланомы moreе чем в два раза. Solarium visit
raises this figure by 75%. Research agency
раковых заmoreваний в структуре ATОЗ классифицирует оборудование для
sunburn as a “risk factor for the development of skin cancer” and refers
tanning equipment for carcinogenic devices.

  • Родинки. There are two types of moles:
    normal and atypical. Onличие атипичных (несимметричных,
    raised above the skin) moles increases the risk of melanoma.
    Also, regardless of the type of moles, the more, the higher
    the risk of transformation into a cancer;
  • Тип кожных покровов. Люди с moreе нежной кожей
    (they are characterized by light hair and eye color) belong to the group
    increased risk.
  • Anamnesis. If you previously had melanoma
    or another type of skin cancer, and you have recovered, the risk of recurring
    развития заmoreвания существенно увеличивается.
  • Weakened immunity. Negative impact
    on the immune system of various factors, including chemotherapy,
    трансплантацию органов, ATИЧ/СПИД и другие иммунодефицитные
    conditions increase the likelihood of developing melanoma.

ATажную роль в отношении развития раковых заmoreваний, включая
melanoma, plays heredity. About each
There is a close relative in the tenth melanoma patient,
страдающий или перенесший это заmoreвание. Burdened family
history includes melanoma in parents, siblings,
sisters and children. AT данном случае риск появления меланомы повышается
by 50%.

Types of melanomas

By type, melanomas are divided into 4 categories. Three of them are different.
gradual beginning with the development of changes only superficial
skin layer. Such forms very rarely acquire an invasive course.
The fourth type is characterized by a tendency to germinate rapidly.
skin and spread to other parts of the body and internal organs
the patient.

Superficial (superficial) melanoma

является наиmoreе распространенным вариантом течения заmoreвания
(70% of cases). it меланома кожи, симптомы которой характеризуются
long-term preservation of relatively benign growth in
upper (outer) layer of skin. Only after a long time
периода времени суперфициальная меланома прорастает в moreе
deep layers.

The first sign of this type of melanoma is the appearance of a flat
asymmetrical spots with irregular borders. Color on the affected
the area changes, becoming brown (like tan), black,
red, blue or white. Such melanomas can occur on site.
moles. Несмотря на то, что заmoreвание может возникнуть на любом
участке кожи, moreе вероятно развитие данных симптомов на туловище
(in men) and in the legs (in women), as well as in the upper back
(regardless of gender).

Malignant lentigo

downstream is similar to superficial melanoma, as long
time develops in the upper layers of the skin. ATизуально лентиго
manifested as a flat or somewhat raised unevenly
colored skin area. The color of the stain is mottled with brown and
темно-коричневыми elementми. This type of melanoma is “in place” more
often recorded in elderly patients due to constant
chronic exposure to solar radiation and develops usually
on the face, ears, arms, and upper torso. it наиmoreе
A common form of melanoma in Hawaii. When going to
инвазивную стадию, заmoreвание называют лентиго-меланомой.

Acral lentiginous melanoma

also develops superficially before continuing growth
deep into the skin. This form differs from the others in that
appears as black or brown spots under the nails, on
palms or feet. Заmoreвание прогрессирует быстрее, чем
previous forms and more often affects black people. it наиmoreе
common form among Africans and Asians, while
Caucasians and Europeans are the least affected.

Nodular melanoma

is an invasive course option. Usually by the time
the discovery it already grows deep enough into the skin. Externally
such a melanoma resembles a lump. Usually it is black but
there are other options (blue, gray, white, brown,
red or even unchanged, color). Localized more often on
torso, legs and arms. Mostly affects older people. it
the most aggressive variant of the course of melanoma. She is diagnosed in
10-15% of cases.

Symptoms of Melanoma

Melanoma can develop from an already existing mole or on
фоне другого кожного заmoreвания, но часто она возникает на
unchanged skin. Onиmoreе распространенной локализацией меланомы
are the legs and the top of the back. Due to continued production
altered melanin cells the tumor has black or brown
color, but colorless melanomas are also found.

Less often, melanomas occur on the palms, nails and mucous membranes.
shells. Older people often have melanomas on the face, and
also on the neck, scalp and ears.

Early symptoms of melanoma

The main symptoms of melanoma are resizing,
shapes, colors of existing moles or “birthmarks” or
the appearance of unpleasant sensations in this area. Development
these symptoms can take a long time (several
weeks or months). In addition, melanoma may initially
be perceived as a new mole, but at the same time have an unpleasant
appearance. The appearance of such a subjective symptom should
serve as a warning sign and a reason to visit a doctor.

The first signs of melanoma include:

  • Bleeding
  • Burning sensation
  • Crust formation
  • Change in the height of the spots (thickening or elevation above the skin)
    moles that used to be flat)
  • Ulceration, itchy skin
  • Change in consistency (the mole becomes soft)
  • The appearance of any discharge in the area of ​​the tumor
  • Increased size of the modified focus
  • Redness or swelling of surrounding tissue
  • The emergence of new small areas of pigmentation around the main

Late symptoms of melanoma

Further development is characterized by the following symptoms.

  • Violation of the integrity of the skin
  • Mole bleeding
  • Bleeding from other pigmented skin
  • Pain in the affected area

Symptoms of metastatic melanoma

These symptoms develop when cancer cells enter.
melanomas in the bloodstream and spreading them to others

  • Chronic cough
  • Seal under the skin
  • Gray skin tone
  • Constant headache
  • Cramps
  • Enlarged lymph nodes
  • Unexplained weight loss, exhaustion

You must immediately consult a doctor if you have

  • Bleeding из родинок или в участках пигментации
  • Discolouration of nails on hands and feet, not caused
  • Asymmetric growth of moles or separate skin areas
  • Darkening of the skin, not associated with sunburn
  • The appearance of pigmentation sites with jagged edges
  • The appearance of moles with areas of different colors (distribution
    pigmentation from birthmarks to the surrounding tissue is an early sign
  • Увеличение диаметра moreе 6мм

Stages of melanoma

According to the new approved international classification,
determining the stage of the course of melanoma by diagnostic criteria
are the thickness of the tumor (thickness Breslow), the presence
microscopic ulceration and the rate of division of cancer cells.
Благодаря новой системе стало возможным поставить moreе точный
диагноз и планировать наиmoreе эффективное лечение.

Breslow thickness is measured in millimeters and characterizes
the distance from the top layer of the epidermis to the deepest point
germination of the tumor. The thinner the melanoma, the higher the chance of cure.
Данный показатель – наиmoreе важный аспект в прогнозировании
course and effectiveness of therapeutic measures.

  • 1 and 2 stages

melanomas are characterized by a limited tumor. it означает,
that cancer cells do not yet metastasize to lymph nodes or other
organs. At this stage, the risk of re-development of melanoma or
further spread of the tumor is quite low.

Depending on the thickness, there are:

  • In situ melanoma (“in situ”). it начальная стадия, когда
    the tumor has not yet grown into the epidermis. This form is also referred to
    zero stage;
  • Thin tumors (less than 1 mm). Development опухоли свидетельствует о
    initial (first) melanoma stage;
  • Average thickness (1 – 4 mm). From now on
    melanoma enters the second stage;
  • Толстые меланомы (moreе 4 мм в толщину).

The presence of microscopic ulcers exacerbates the severity
заmoreвания и означает переход к поздним стадиям. Division rate
cell is also an important criterion in determining the prognosis
flow. Even a single confirmed process of dividing culture
cancer cells per square millimeter characterizes the transition to
moreе тяжелым стадиям течения меланомы и повышает риск
metastasis. AT данном случае методом выбора является moreе
aggressive treatment tactics to achieve the desired effect. On
first and second stage for melanoma is characterized by asymptomatic
increase in the size of pigmentation sites, their elevation above the level
кожи без кровоточивости и moreвых ощущений.

  • Stage 3

On данной стадии наблюдаются важные изменения в течение
заmoreвания. On этом этапе толщина Бреслоу уже не принимается во
attention, but revealing becomes ulceration.

The third stage is characterized by the spread of tumor cells.
to lymph nodes and surrounding skin. Any spread
опухоли за границы первичного hearth характеризуется. As a transition to
third stage. it подтверждается с помощью биопсии ближайшего к
lymph node tumors. Now such a diagnostic method
показан при увеличении размеров опухоли moreе 1 мм или при наличии
signs of ulceration. The third stage is characterized by the above.
late symptoms of melanoma (pain, bleeding, etc.).

  • Stage 4

означает, что клетки опухоли метастазируют в отдаленные organs.
Metastases for melanoma spread to (by the time of involvement in
pathological process):

  • Lungs
  • Liver
  • Brain
  • Bones
  • Gastrointestinal tract

On данном этапе появляются симптомы метастазирующей меланомы,
which depend on the defeat of an organ. On 4 стадии
melanoma has a very poor prognosis, the effectiveness of treatment
is only 10%.

What does melanoma look like? – photo

Меланома симптомы Признаки меланомы
Malignant melanoma is not always dark
pigmentation. Because of this, it is often difficult to put the right one.
Photos taken at a certain time interval
help assess the degree of tumor growth and resizing
Left – Monochrome Right – Color varies within one
Left – Smooth edges. Right – No clear border.
Left – Normal Mole Right – Reshaping, resizing and
Left – Normal mole (symmetrical) Right – Melanoma
 Меланома на ногтях  Melanoma on the face
The brown or dark line along the fingernail should be considered
as a malignant melanoma, especially if there is unevenness
edges and its gradual thickening.
 Melanoma on the face


Diagnostics меланомы является достаточно затруднительной задачей
even for an experienced dermatologist. Since it is not always in the first place
characteristic symptoms appear, it is necessary to pay a large
attention to self-diagnosis and notify the doctor
immediately after the detection of a suspicious mole or spot.
it особенно важно, если у ваших близких родственников отмечалось
подобное заmoreвание. After examination to confirm the diagnosis of the doctor
may order a skin biopsy as well as a biopsy
lymph nodes. The final diagnosis of melanoma is confirmed
only after histological examination of the biopsy. Derived from
патологического hearth.

Early detection of melanoma can save the patient’s life. For
This is recommended monthly self-examination for
timely detection of skin changes. For этого не нужно
special adaptations. All you need is bright
a lamp, a large mirror, a hand mirror, two chairs and a hairdryer.

  • Examine the head and face with one or both mirrors. For
    use a hair dryer to check the scalp;
  • Check your skin, including nails. With the help of mirrors, inspect
    elbows, shoulders and armpits;
  • Carefully evaluate the condition of the skin on the neck, chest and torso.
    For женщин обязательно проверять кожу под молочными железами;
  • Using the mirror, inspect the back, buttocks and back of the neck,
    shoulders and legs;
  • Carefully evaluate the condition of the skin on the legs and feet, including
    nails Be sure to inspect the knees;
  • Use a mirror to examine the skin on the genital

If you find suspicious elements of pigmentation, compare
them with melano photos below.


Forecast заmoreвания зависит от времени выявления и степени
tumor progression. With early detection, most
melanomas are well treated.

Deep sprouting melanoma, or spreading to
lymph nodes, increases the risk of re-development after
treatment carried out. If the depth of the lesion exceeds 4 mm or
there is a lesion in the lymph node, then there is a high probability
metastasis to other organs and tissues. When secondary
foci (stages 3 and 4) treatment of melanoma becomes

If you had a melanoma and you recovered, it is very important
regularly conduct self-examination because for this category
пациентов риск повторного развития заmoreвания очень высок.
Melanoma can recur even after several years.

The degree of survival for melanoma varies widely in
зависимости от стадии заmoreвания и проводимого лечения. On первой
стадии излечение наиmoreе вероятно. Also, a cure can
occur in almost all cases of second stage melanoma. Patients,
those who received treatment in the first stage have a 95% five-year
survival rate and 88 percent decade. For второй стадии данные
rates are respectively 79% and 64%.

On 3 и Stage 4х рак распространяется в отдаленные органы, что
leads to a significant decrease in survival. Five year old
the survival rate of patients with stage 3 melanoma is (for various
data) from 29% to 69%. Ten-year survival rate provided
only 15 percent of patients.

Если заmoreвание перешло в 4 стадию, то шанс пятилетней
survival rate decreases to 7-19%. Ten year statistics
there is no survival for patients with stage 4.

The risk of recurrence of melanoma increases in patients with large tumors.
in the presence of ulcerations of melanoma and nearby
metastatic skin lesions. Repeated melanoma may occur
like in the vicinity of the previous location,
and at a considerable distance from it.

Despite the fact that this form of cancer looks scary, the prognosis
his treatment does not always remain unfavorable. Even with repeated
the onset of early treatment leads to a cure and
provides long-term patient survival.

Автор: Коробов Никита Александрович врач-анестезиолог

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