How to identify skin melanoma

Melanoma is the most dangerous type of cancer. It is characterized by asymptomatic development and rapid metastasis. It is important to recognize melanoma at an early stage. Timely diagnosis of skin cancer will preserve the health and life of the patient.

Factors that can trigger the development of melanoma

A tumor can appear at any age, on any part of the body, regardless of a person’s gender or age. It is characterized by the formation of a dark spot or nodule with a high content of melanin, a natural pigment.

The neoplasm can affect the skin or mucous membrane. Also, the place of formation can be the esophagus, intestines, anal sphincter, genitals, or skin under the nails. A rare occurrence is the appearance of a tumor in the eye, which causes a sharp decrease in vision, loss of an organ, or death of the patient. 90% of all cases of the disease occur on the skin of the body.

It is difficult to name the exact and unambiguous reason for the appearance of this pathology. Doctors identify several factors that determine the risk of cell degeneration:

1. Light skin and natural red hair.
2. A significant number of moles and pigmented spots on the body (more than 50).
3. The presence of freckles, their reappearance.
4. Significant size of birthmarks (2 cm in diameter or more).
5. Trauma to a mole, nevus.
6. Ultraviolet radiation, visiting a solarium.
7. Sunburn.
8. Complicated family history.
9. Elderly age.

In the fair sex, a “bad” nevus or mole usually affects the skin on the extremities, where it is easier to identify. In men, the place of formation is the torso, groin area, neck, and head. This location of the cancerous tumor threatens the rapid spread of metastases to the lymph nodes and internal organs. It is important to be able to independently identify melanoma at an early stage.

First signs

If it is possible to recognize melanoma at the beginning of its development, then the patient has every chance of a full recovery. People at risk need to regularly take time for self-examination.

The first signs of melanoma:

1. growth of a mole, nevus or birthmark;
2. uneven edges, blurred boundaries of the formation;
3. change in shade (usually significant darkening or uneven coloring is observed);
4. asymmetrical spot shape;
5. the size of the formation is more than 6 mm;
6. the appearance of cracks, rashes, ulcers on the surface of the mole;
7. bleeding, itching, pain and other symptoms.

Any change from the above should cause concern in a person. Lesions on the face, limbs, back, head, and abdomen are subject to examination and diagnosis. Melanoma is diagnosed by a dermatologist or oncologist.

The development of melanoma is determined by 4 stages. Recognition of skin cancer at the first stage is characterized by the most favorable prognosis. The second phase is curable due to the absence of metastases. In the third phase of the disease, metastasis and damage to a nearby lymph node are observed. In such conditions, treatment becomes more complicated, and the chances of recovery decrease. Stage 4 cancer is critical. At this level, malignant cells penetrate the organs, the state of health deteriorates significantly, weight loss, headaches, and decreased vision are observed. It is very rare that a patient can be saved.

Due to the aggressiveness of this type of cancer, any change in the appearance of a mole should be accompanied by a visit to a doctor. The only treatment for melanoma is surgical removal. Self-medication at home threatens the patient with complications or death.

How to independently recognize melanoma at home: self-examination rules

It is also necessary to take special interest in new formations on the skin and the appearance of discomfort in the pigmented area. Only a doctor can accurately determine the presence of melanoma using specialized diagnostic methods. The patient’s task is to identify the tumor in time.

An inexperienced person may find it difficult to distinguish melanoblastoma from other skin tumors that do not pose a particular threat to human life. Let's look at the table below of formations that may at first glance cause concern:

The ability to distinguish melanoma from other formations on the skin will help to recognize a malignant tumor in time. It is important to know that melanoblastoma can form on a pigmented area and on clean skin without accumulations of melanin. The appearance of growths accounts for 70% and only 30% of cases of the disease occur due to malignancy of existing moles and nevi.

Professional diagnostics and preventive measures

Examination of a suspicious area of ​​skin begins with a visual examination by a dermatologist. The doctor uses a dermatoscope, a magnifying device, to examine surface changes in the mole.

Modern equipment makes it possible to perform epiluminescent computer dermatoscopy. This diagnostic method is safe, painless, non-invasive. The device can take pictures with multiple magnification of the problem area, which makes it possible to display it on a digital screen and further analyze it thoroughly.

Once the diagnosis is confirmed, treatment is prescribed, the specifics of which depend on the condition of the tumor, its stage, and the presence or absence of metastases. Removal of melanoblastoma is performed exclusively by surgical method, and the excised formation is sent for histological examination.

To prevent the development of skin cancer, it is necessary to avoid prolonged exposure to sunlight and not overuse visits to the solarium. Using sunscreen reduces the risk of disease. A preventative measure would be self-examination of moles at home. Determining the presence of a tumor at the initial stage is the key to successful therapy.

Skin melanoma is one of the most malignant human tumors, often with an unpredictable course. You can now find a huge number of “articles” on the topic of melanoma on the Internet. The vast majority of them do not have an author, a huge number are written by people without medical education. Reading such materials can lead an unprepared person to neurosis.

Very often on the Internet I answer questions related to one or another sign of melanoma. Most often people find one of the symptoms and give themselves a fatal diagnosis. The main thing I want to say in this article is that one single sign of melanoma, in itself, is not a reason for panic and suspicion regarding this disease.

16 signs of melanoma

Now it is necessary to give all the signs by which an inexperienced person might suspect melanoma.

The list, which is given in the book of one of the leading experts in this field, Valentin Vadimovich Anisimov, “Skin Melanoma (Part 2),” seems to me the most complete:

1. horizontal growth of nevus
2. vertical growth of nevus above surrounding tissues
3. the appearance of asymmetry or irregularity of the outlines (scalloping) of the edges of the nevus, i.e., a change in its shape.
4. complete or partial (uneven) change in the color of the nevus, the appearance of areas of so-called associated depigmentation.
5. the appearance of a feeling of itching and burning in the area of ​​the nevus.
6. ulceration of the epidermis over the nevus.
7. wetting of the surface of the pigmented nevus.
8. bleeding from its surface.
9. hair loss on the surface of the nevus.
10. inflammation in the area of ​​the nevus and in the tissues surrounding it.
11. peeling of the surface of the nevus with the formation of dry “crusts”.
12. the appearance of small pinpoint nodules on the surface of the nevus.
13. the appearance of daughter pigmented or pinkish formations (satellites) in the skin around the nevus. 14) change in the consistency of the nevus, determined by palpation, i.e. its softening or loosening.
14. the appearance of a shiny glossy surface of the nevus.
15. disappearance of the skin pattern on the surface of the nevus.

Now that we have listed the 16 signs of melanoma, I will try to show how this list works.

I think that if this is not the first time you are reading about melanoma on the Internet, you have already found one of the symptoms in yourself.

Fortunately, in most cases, there must be several of them, or the rate of change must be high. Now we will analyze them all in detail:

Sign 1 "horizontal growth of nevus"

In almost every person, almost all moles increase at least a little during life. Does everyone have melanoma? I think no.
At the same time, if a mole has grown by several millimeters in a few months, you need to urgently show it to an oncologist.

Signs 2 and 12 - “vertical growth of the nevus above the surrounding tissues”, “appearance of small pinpoint nodules on the surface of the nevus”

Very often, people in panic ask me: “My mole is growing in height and growths are appearing on it! I’m dying.” If everything looks like the picture below, you need to urgently see an oncologist - it’s most likely melanoma.

At the same time, there is a separate type of skin formations - papillomatous nevi. They are also sometimes called warty. Often small papillomatous nodules appear on their surface, which a person without experience can easily attribute to symptom No. 2 or No. 12. The photo below is a typical example of a completely benign mole with nodules that have appeared on the surface:

I talk in more detail about the growth and enlargement of moles in this article.

Sign 3 - “the appearance of asymmetry or irregularity in the outline of the nevus.”

If the nevus has become asymmetrical along two axes, its entire edge has become scalloped or began to remind coastline on the geographical map - it’s time to go to the oncologist.

However, if you look closely at any mole on the body with a magnifying glass, even with low power, you will not find perfect circles or straight lines. In no nevus is the pigment distributed 100% evenly.

You can read more about moles with uneven edges here

Sign 4 “uneven change in color of the nevus (mole), the appearance of areas of so-called associated depigmentation”

Melanoma is characterized by uneven distribution of pigment. If it is melanoma, the depigmentation (lighter area) will be as irregular in shape as the mole itself:

A benign nevus (mole) can also normally have an uneven distribution of pigment, but it will not be as pronounced:

Depigmentation may surround the mole. This most often occurs in halo-nevi:

I discuss moles with uneven coloring in more detail in a separate article.

Sign 5 - “the appearance of itching and burning in the area of ​​the nevus”

Yes, itching and burning can indeed be signs of melanoma. However, any part of the body can itch, including a completely benign mole. In the absence of other signs, all fears are groundless.

You can read more about this sign in this article.

Signs 6 and 7 - “ulceration of the epidermis over the nevus”, “wetting on the surface of the nevus”

In my experience, ulceration appears mainly in melanomas in late stages, when there is no longer any doubt about the diagnosis. This symptom is more relevant, in my opinion, for basal cell skin cancer (basal cell carcinoma). This disease is much less formidable; people die from it extremely rarely.

For a benign mole, an ulcerated surface and weeping are also possible - immediately after trauma:

Sign 8 - “bleeding from the surface of the nevus.”

Yes, indeed one of the common features of melanoma is spontaneous bleeding without previous trauma to the mole. Even this one sign will make any oncologist seriously doubt the benignity of the mole.

However, in my practice several times I came across a rather rare type of skin tumor - pyogenic granuloma. These formations appear very quickly, bleed, however, they are 100% benign:

Sign 9 - “hair loss on the surface of the nevus.”

This sign may indicate that the mole has become malignant. If the mole is 5 mm or more and several hairs have disappeared from its surface at the same time and they do not appear. Moreover, if the same mole began to grow and doubled in size in 2 months, these are already 2 alarming signals at the same time and such a mole should be shown to an oncologist without delay.
In addition, I should note that in my practice once I encountered a melanoma, the surface of which was covered with hair.

At the same time, there are a huge number of moles, the surface of which is not covered with hair and at the same time they are completely benign. People also often panic if one hair grew from a mole and it suddenly fell out. Please do not despair - it should appear no later than in 2-3 weeks.

I wrote this article about hair on moles.

Sign 10 - “inflammation in the area of ​​the nevus and surrounding tissues”

Redness and swelling of the tissue around the mole may be a consequence of melanoma cells growing into the surrounding skin.

However, it must be remembered that in case of inflammation of the sebaceous gland, which is located under or next to the mole, “pimples” may form. If such a focus of inflammation is located next to a mole, you will see symptoms of inflammation - redness and soreness. How to distinguish a “pimple” from a sign of melanoma? It’s very simple - wait 1-2 weeks and it should go away on its own.

Inflammation of a mole is a common occurrence. I analyze it in this article

Sign 11 - “peeling on the surface of the nevus with the formation of dry crusts”

Yes, the surface of melanoma (or basal cell carcinoma) can be covered with crusts that form due to weeping or bleeding. And this is a truly alarming sign.

At the same time, there is another type of neoplasm - keratopapillomas (keratomas). Crusts regularly appear on the surface of such formations, which then fall off.

Sign 13 “the appearance of daughter pigmented or pinkish formations (satellites) in the skin around the nevus”

In later stages, melanoma can give intradermal metastases, which appear as black formations around the primary tumor focus.

At the same time, very often people mistake for this symptom the usual appearance of a new mole next to an existing one. In the vast majority of cases there is nothing wrong with this:

Sign 14 - “change in the consistency of the nevus, determined by palpation, i.e. its softening or loosening”

Unfortunately, I cannot comment on this sign. All melanomas encountered in my practice were quite dense and none of the patients noted softening.

Sign 15 - “the appearance of a shiny glossy surface of the nevus”

Melanoma cells refract and reflect light rays in a special way. The consequence of this may be the appearance of a glossy surface on the mole.

At the same time, there is a separate type of skin tumors - blue nevi. These moles very often have a glossy surface and are completely benign:

Sign 16 - “disappearance of the skin pattern on the surface of the nevus”

Most often, there is no skin pattern on the surface of melanoma. This is due to the fact that tumor cells lose their normal functions and engage in only one thing - constant division. As a result, after the mole degenerates, the skin pattern disappears.

At the same time, there are a huge number of benign moles on the surface of which there is no skin pattern:

I don’t see any point in further detailed analysis of all the signs. All of them can be interpreted in two ways - both in favor of melanoma and in favor of benign changes. Only the presence of two signs at once or the rapid onset of changes can indicate a malignant mole.

I think that I was able to clearly show you that each of these signs separately cannot clearly indicate melanoma.

Briefly about the main thing:

Don’t panic if, after reading horror stories on the Internet, you find yourself with a sign of melanoma! Most likely everything is fine.
The presence of only one of the 16 symptoms is very unlikely to indicate a malignant mole. Each of them individually can occur in benign neoplasms.

If a symptom develops over several months, you should definitely see an oncologist.

The likelihood of melanoma is very high if there is more than one sign - in this case, be sure to see an oncologist. You should also come to this doctor if you have even the slightest doubt that your mole is benign.

If you still have questions, the following will help you:

Melanoma, what is it?

Melanocytes synthesize pigments responsible for coloring the skin, eye color, and hair. Pigmented formations filled with melanin are called moles and can appear throughout life. Certain causative factors of an exogenous (from the Greek “exo” - external) and endogenous (“endo” - internal) nature can cause malignancy of nevi. As a result, areas of the body where there are congenital or acquired nevi are at risk of developing melanoma: the skin, less often the mucous membranes and the retina. The altered cells are able to multiply and grow uncontrollably, forming a tumor and metastasizing. Most often, among benign “brothers”, a single malignant neoplasm is discovered.

The clinical picture is varied. The size, outline, surface, pigmentation, and density of the tumor vary widely. Any changes that occur with a mole should alert you.

Character traits

A melanoma tumor developing from a nevus is characterized by a prolonged increase in changes (up to several years) and subsequent aggressive transformation (1-2 months). Early self-diagnosis and timely examination by a specialist will help identify the symptoms of melanoma:

1. Smooth mirror surface, with disappearance of skin grooves.
2. Increase in size, growth over the surface.
3. Unpleasant sensations in the area of ​​the mole: itching, tingling, burning.
4. Dryness, peeling.
5. Ulceration, bleeding.
6. Signs of an inflammatory process in the area of ​​the mole and surrounding tissues.
7. The emergence of subsidiaries.

The sudden appearance of subcutaneous lumps and nodules may also indicate a developing disease.

Clinical classification. Types of melanoma

Melanoma manifests itself in various forms, there are 3 main types:

Tumor of melanocytic origin. The most common disease (70 to 75% of cases) among middle-aged Caucasians. Relatively small, complex in shape with uneven edges. The color is uneven, reddish-brown or brown, with small patches of bluish tint. The neoplasm tends to become a tissue defect, accompanied by discharge (usually bloody). Growth is possible both on the surface and in depth. The transition to the vertical growth phase can take months or even years.

What does melanoma look like in a photo?

1. Nodal.

Nodular (diminutive from the Latin “nodus” - node) formation is less common (14-30%). The most aggressive form. Melanoma cancer characterized by rapid growth (from 4 months to 2 years). Develops on objectively unchanged skin without visible damage or from a pigmented nevus. Growth is vertical. The color is uniform, dark blue or black. In rare cases, such a tumor, which resembles a nodule or papule, may not be pigmented.

1. Malignant lentigo.

The disease affects older people (after 60 years) and is detected in 5-10% of cases. Open areas of the skin (face, neck, hands) are covered by dark blue, dark or light brown nodules with a diameter of up to 3 mm. Slow radial growth of the tumor in the upper parts of the skin (20 years or longer before vertical invasion into the deep layers of the dermis) can involve the hair follicles.

The first signs of melanoma

Melanoma is acquisition by cells of unfavorable signs of malignancy (malignancy properties), expressed by various symptoms.

To make it easier to remember the signs of melanoma, use the “FIGARO” rule:

Shape – swollen above the surface;

Changes – accelerated growth;

Borders are openwork, irregular, jagged;

Asymmetry - the absence of mirror similarity of the two halves of the formation;

Size – a formation with a diameter of more than 6 mm is considered a critical value;

Coloring – uneven color, inclusion of random spots of black, blue, pink, red.

In widespread practice, the English version is also popular, summarizing the main, most typical features - the “ABCDE rule”:

Asymmetry - asymmetry in which, if you draw an imaginary line dividing the formation in half, one half will not be similar to the other.

Border irregularity - the edge is uneven, scalloped.

Color – a color that is different from other pigment formations. Interspersed areas of blue, white, and red colors are possible.

Diameter – diameter. Any lesion larger than 6 mm requires additional observation.

Evolution – variability, development: density, structure, size.

Without special studies, it is difficult to determine the type of nevus, but timely changes in the nature of the spot will help detect malignancy.

Diagnostics

1. Visual method. Examination of the skin using the “rule of malignancy.”
2. Physical method. Palpation of accessible groups of lymph nodes.
3. Dermatoscopy. Optical non-invasive surface examination of the epidermis using special devices providing 10-40x magnification.
4. Siascopy. Hardware spectrophotometric analysis, which consists of intracutaneous (depth) scanning of the formation.

1. X-ray.
2. Ultrasound of internal organs and regional lymph nodes.
3. Cytological examination
4. Biopsy. It is possible to collect both the entire formation and its parts (excisional or incisional).

Stages of melanoma

The tumor has several stages of development.

1. In case of zero and first, tumor cells are located in the outer layer of the dermis (locally);
2. On the second and third – the development of ulcerations in the lesion, spreading to the nearest lymph nodes (local-regional);
3. On the fourth – damage to lymph nodes, organs, and other areas of human skin (distant metastasis).

Treatment

1. Treatment of local local injuries consists of timely detection and surgical intervention. Removal is most often performed under infiltration anesthesia. For excision of large formations, general anesthesia may be used. In addition to malignant tumors, there are a number of pre-melanoma diseases in which the surgical method is indicated.
2. Local-regional damage. Treatment includes wide-area excision and lymph node dissection of the affected lymph nodes. Types of unresectable, transiently metastatic tumors are subjected to isolated regional chemoperfusion. In certain cases, a combined approach has proven itself to be effective, with additional therapy that stimulates the immune system.
3. Treatment of distant metastases is performed with monomodal chemotherapy. Certain types of mutations are targeted by targeted drugs.

Melanoma. Survival prognosis

The thickness of the neoplasm, the depth of invasion, localization, the presence of ulcerations and the radicality of the intervention in the treatment of the disease have important prognostic significance.

Radical treatment of superficial melanomas provides a five-year survival rate of 95 percent. A tumor involving the lymph nodes reduces this percentage to 40.

Contraindications

A person’s belonging to a photosensitive phototype, a large number of nevi, atypical moles, the presence of a hereditary predisposition, immune and endocrine disorders are additional factors in favor of careful attention to skin neoplasms. Contraindicated:

1. Traumatization
2. DIY mole removal
3. Prolonged exposure to UV radiation without skin protection

Treatment after surgery

For local stages, observation is carried out for 5 years. 10 years – for other forms. This period is considered sufficient to detect the occurrence of a relapse of the disease. The patient is instructed to use appropriate means of protection against UV rays, in conditions of natural and artificial radiation.

Author's publication:
GAFTON IVAN GEORGIEVICH
oncologist
National Medical Research Center of Oncology named after N.N. Petrova

Photos from personal archive:
RAJABOVA ZAMIRA AKHMEDOVNA
oncologist, head of the surgical department of head and neck tumors
National Medical Research Center of Oncology named after. N.N. Petrova