Stages of Melanoma

stage_4_melanoma

Stages of Melanoma

The following stages are used for melanoma:

  • Stage 0: In stage 0, the melanoma cells are found only in the outer layer of skin cells and have not invaded deeper tissues.
  • Stage I: Melanoma in stage I is thin:

    The tumor is no more than 1 millimeter (1/25 inch) thick. The outer layer (epidermis) of skin may appear scraped. (This is called an ulceration).
    Or, the tumor is between 1 and 2 millimeters (1/12 inch) thick. There is no ulceration.

    The melanoma cells have not spread to nearby lymph nodes.

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Melanoma

melanoma

Melanoma is a serious type of skin cancer found throughout the body, bust mostly on areas that have had sun exposure such as your back, legs, arms and face. It is a disease in which malignant cancer cells form in the skin cells (melanocytes). Melanocytes are found on the lower part of the epidermis. Melanomas can also occur in areas that don’t receive much sun exposure, such as the bottom of your feet, palms of your hands, and fingernails.  The “hidden” melanomas are more common in darker skin toned people.

Melanomas don’t always begin as a mole, although most do. It can also occur on normal skin. That’s why it is very important to do self-skin exams to detect for possible melanomas.

Melanocytes and Skin

Melanocytes and Moles

Melanocytes are the skin cells which produce the skin pigment Melanin. Melanin is the pigment which lends skin its natural color. When skin is exposed to the sun, melanocytes produce more pigment causing the skin to darken.

Sometimes melanocytes and surrounding tissue can form darker noncancerous growths called moles. Moles are very common, and most people have up to 40 moles ranging from pink to tan to dark brown. Moles can be raised or flat,and are generally round or oval and smaller than 1/4 inch in diameter. (Technically a mole is properly called a nevus; the plural is nevi.)

Melanoma occurs when Melanocytes turn malignant.

Diagnosis of Melanoma

If your doctor suspects that a spot on your skin might be melanoma, She will generally take a small tissue sample called a biopsy. This is generally done by numbing up the skin around the mole, and using a small scalpel to remove the suspicious tissue along with a small margin of healthy tissue. The sample is then sent to an expert pathologist who will review the cells under magnification and determine whether the tissue is healthy or malignant. A biopsy is the only way to make a definite diagnosis. During the biopsy the doctor tries to remove all of the suspicious-looking growth so that the diagnostice procedure is also curative.

Staging

If the diagnosis is melanoma, the doctor needs to learn the extent of the disease before planning treatment. The medical team establishes how thick the tumor is, how deeply it has invaded the skin, and whether the malignant cells have spread to the lymph nodes or other parts of the body.

This process is called Staging, and the melanoma is assigned a stage. The stage of the melanoma will help indicated the course of treatment.

Depending on the apparent stage of the malignancy, the doctor might order removal of nearby lymph nodes (as both a diagnostic and therapeutic measure). If the tumor is thick, may order chest x-rays, blood tests, and scans of the liver, bones, and brain.

Treatment

Options for treatment depend on different factors such as stage of melanoma, location and size, and the individual’s general health. One common treatment is surgical excision. Most people with a early case of melanoma can get it cut out. The surgery is less extensive and results in little scarring.

Other treatments include radiation therapy and lymph node dissection. Radiation therapy will direct high-energy rays at the melanoma, which kills the malignant cells. Lymph node dissection removes most or all of the lymph nodes in the region.

Consult your dermatologist or physician for more information on symptoms and treatment of melanomas.

Read more about the stages of Melanoma and the corresponding treatment regiments here.


The National Cancer Institute has a toll free information line available for patients and their familes. The specialists at the NCI’s Cancer Information Service at 1-800-4-CANCER can answer questions about melanoma and can send NCI materials

Dysplastic Nevi

dysplastic_ nev_ visual_guide_ 1

Background

Otherwise known as unusual moles that may resemble melanoma. People who have 10 or more of these moles have 12 times the risk of developing melanoma. Those who have dysplastic nevi plus a family history of skin cancer have an extremely high risk of melanoma.

The Classic Atypical Syndrome

People with a classic atypical mole syndrome have the following three characteristics:

  • 100 or more moles
  • One or more moles 8 mm (1/3 inch) or larger in diameter
  • One or more moles which are atypical.

Characteristics

Atypical melanocytic nevus – asymmetric, border is irregular, color varies, diameter is greater than 6mm.

Multi-colored nevus – has a wreathed-shaped appearance, common patterns.

SHAPE: often asymmetrical: A line drawn through the middle would not create matching halves.

BORDER: irregular and/or hazy—the mole gradually fades into the surrounding skin.

COLOR: variation and irregularity with subtle, haphazard areas of tan, brown, dark brown, red, blue or black.

DIAMETER: generally larger than 6 mm (1/4 inch), the size of a pencil eraser, but may be smaller.

LOCATION: most commonly on the back, chest, abdomen and extremities; may also occur on normally unexposed areas such as the buttocks, groin or female breasts, as well as on the scalp.

GROWTH: Enlargement of a previously stable mole or appearance of a new mole after ages 35–40 should raise suspicion.

SURFACE: Central portion often is raised, whereas the peripheral portion is usually flat, sometimes with tiny “pebbly” elevations.

APPEARANCE: greatly varied; dysplastic nevi often look different from one another.

NUMBER: From a few to well over 100 dysplastic nevi may be present.

Here’s a quick visual guide from Cancer.Gov:

For more information, please visit and/or call your physician.

Here are some great resources to learn more about Dysplastic Nevi:

SkinCancer.Org

American Association of Dermatology

Cancer.Gov

Nevus.Org

All Grown Up: Dealing with Adult Acne

adult_acne_treatment

Adult acne affects 25% of men and 50% of women at some point in their adult lives. People can develop unpleasant acne and continue to have recurrences in their 20s, 30s, 40s or beyond. Nowadays, dermatologists are treating more adult acne patients than in previous decades. The International Journal of Cosmetic Science 2004 stated, “Recent epidemiological studies show that there appears to be an increase in post-adolescent acne, and that the disease is lasting longer and is requiring treatment well into the mid forties.” Regardless of age, dealing with acne can be a struggle and may possibly lead to depression and social anxiety. However, the more you know about it, the better.

What’s the Cause?

Causes of adult acne are attributed to, but not limited to: hormones, cosmetics, stress, and an increase of resistant bacteria. Hormones can cause the sebaceous glands in your body to overact and is most likely related to birth control pills. Careless use of cosmetics can lead to bacteria-laden pores. Stress causes your oil glands to overcompensate.

Good news for all the chocolate and junk food lovers out there: skin care experts say that acne is not caused by any specific food, including French fries, chocolate candy, soda or potato chips. The other myth you’ve probably heard is that eating greasy food causes your skin to produce more oil. Other than it being unhealthy, greasy food will not cause oily skin.

How To Treat It

The key in treating adult acne is to know that it is not like teen acne. Most acne medications are geared to teenagers’ oily skin, which is a bad choice for drier adult skin. The best recommendation is to have a trial-and-error approach and experiment with cleansers, creams and lotions, prescription medications, or high-tech solutions.

You’re Not Alone… Consult Your Doctor

Most people wait it out before seeking professional help, when in reality, your doctor or dermatologist can help you treat adult acne faster than you’d think. Of course, there are over-the-counter remedies you can try at home, but don’t feel hesitant to see your dermatologist who can prescribe just what you need.

Professionals can also help remind you to keep a healthy diet. A natural diet consists of fresh fruits and veggies, whole grains, and lean protein. This will help create a healthy body, in turn creating healthy, clear skin. Like we said, eating junk foods won’t cause acne, but at the same time, eating healthy foods will help prevent your chance with adult acne.

Holy Zit ! Where did you come from?

acne_pimple

Everyone knows what zits and pimples are. We’ve come to an agreement that it’s just a part of puberty and growing up, right? Wrong. Acne, the formal term, has a science behind it and there are several factors that cause the evolution of the dreaded pimple.

What’s the cause?

First off, know that acne blemishes begin approximately 2 weeks before it actually becomes visible. It is a long process that starts in your pores. Our skin is quite regenerative—new cells replace the old ones and that’s how skin maintains itself. However, everyone’s regeneration process is different—you might shed cells evenly or unevenly. Uneven shedding causes dead cells to become sticky clumps, which eventually will form a plug. This plug traps oil and bacteria inside the pore. The pore then begins to swell which causes white blood cells to swarm around it and attack the bacteria. Lo and behold, the dreaded pimple.

There are several categories of acne, as listed below:

  • Whiteheads: the small whitish bumps. They are caused by an accumulation of oils that plugs your skin’s follicles, creating lesions. The lesions turn into whiteheads as these clogged areas are not exposed to air.
  • Blackheads: the small black bumps, typically on your nose or T-zone. They are caused by too much oil that somehow becomes exposed to air, which turns the bumps black. Blackheads are not caused by dirt, which is a common misconception.
  • Papules: a fancy name for an inflamed whitehead. They are small, firm cone-shaped, and pink in color. They don’t contain any pus so you should never try to pop them.
  • Pustules: like papules, these are small, round lesions. They are red in color with yellowish or whitish centers, caused by pus. They are usually inflamed, which is a result of chemical irritation from free fatty acids. Most of us are very tempted to pop these types of pimples—but don’t do it! You will most likely end up with a permanent scar. If you have a particularly bothersome pustule, see your dermatologist to have it expressed properly.
  • Conglobata: these are uncommon but severe acne that affects your back, buttocks, chest, shoulders, upper arms, thighs, and even face. These are a combination of pustules and nodules, as well as bacterial infections. The cause of these is unknown, but it often develops if there exists acne or dormant acne that suddenly resurfaces.
  • Nodules and Cysts: Nodules are very inflamed and painful because they lodge deep within the skin. Cysts are softer, pus-filled lesions that are also deep inside your skin.Both of these forms of acne could last for weeks or even months. Nodular acne can develop into cysts, although not always. If left untreated, they are likely to cause scarring. Nodular and cystic acne is most common in teenage boys and young men, although they can affect anyone. They are often genetically caused.

Treatment & Prevention

The key to successful acne treatment is giving it time to work. There are no overnight cures, and acne doesn’t just go away. There are several types of treatment including benzoyl peroxide, tetracycline, tretinoin (or Retin-A), isotretinoin, laser treatment and herbal remedies. Because your body and skin is unique to you, you need to test several treatments to see what works for you. Don’t be fooled by brand names, but instead, make sure you know what the active ingredients are in each product. Research is very important in identifying and treating acne.

Preventing acne is definitely easier than treating it. As long as you understand your skin and what causes acne, you can easily prevent it from happening. Be consistent in managing good hygiene and take note of outside factors such as the weather, your diet, and stress level. Acne prevention can be a very part of your daily routine.

Sunburn – Your Mom Was Right. Put on Sunscreen.

uv radiation by time of day

Sunburn is a burn to the skin after overexposure of ultraviolet radiation. Symptoms can include, redness, pain, itching, peeling skin, rash, nausea, fever, and syncope. In severe cases, blistering can appear. Extreme sunburns can be extremely painful and may possibly require hospital care.

If you were born before the 1980s, you probably remember the old coppertone billboards. A cute little kid and a feisty little dog making it clear that a “healthy tan” and a nice “copper tone” were the goals of the summer sun season. No self respecting kid wanted to let their mom smear a gob of white, pasty zinc oxide on his nose. We didn’t even call it sunscreen in those days, we called it “suntan lotion”, and your sister might have even smeared on baby oil to amplify the suns effects.

It turns out that George Hamilton was wrong, and your mom was right.

Here are some things to keep in mind regarding sunburns:

  • There is no such thing as a “healthy tan.” Unprotected sun exposure causes premature aging of the skin.
  • Sun exposure can cause first and second degree burns.
  • Skin cancer usually appears in adulthood, but is caused by sun exposure and sunburns that began as early as childhood.
  • You can help prevent skin cancer by protecting your skin and your children’s skin from the harmful rays of the sun.

The first step to treating your sunburn is to avoid any exposure to the sun while in the healing process. The best treatment for sunburn is time since most burns heal within a couple of weeks. However, there are medical treatments such as aspirin, nonsteroidal anti-inflammatory medications (NSAIDs), moisturizers, and compresses.

Another interesting thing to note about sunburn is that is happens on more than just your skin, but also your eyes and lips. The eyes are very sensitive and need UV protection which can be provided in sunglasses. UV light can also cause pterygium and cataracts. The lips can be burned and blistered if overexposed to the sun. The best prevention is to apply a lip balm, such as petroleum jelly, that has an SPF.

So what is Ultraviolet Radiation (UV) anyways?

Ultraviolet (UV) radiation is that section of the electromagnetic spectrum between x rays and visible light, i.e., between 40 and 400 nm. The UV spectrum is divided into five classifications.

  • Vacuum UV (40-190 nm)
  • Far UV (190-220 nm)
  • UVC (220-290 nm)
  • UVB (290-320)
  • UVA (320-400 nm).

The sun is our main natural source of UV radiation. Manmade sources include tanning booths,mercury vapor and halogen lamps,fluorescent and incandescent lighting, black lights, germicidal lamps,and certain lasers. Depending on the wavelength range of the emitted UV radiation, each source caries its own unique risks..

The atmosphere absorbs almost all Vacuum UV, Far UV and UVC so they are almost never observed in nature. The most common sunburn risks are the result of UVB. It has enough energy to cause damage to cellular DNA, yet not enough to be completely absorbed by the atmosphere. Individuals working outdoors are at the greatest risk of UVB effects. Most solar UVB is blocked the atmosphere, but that absorption varies by time of day, season, weather and other environmental factors.

The best defenses against sunburn are moderating your time in the sun and using proper SPF rated sunscreens and sunblocks to protect your skin when you are exposed.

Birthmarks – How to Tell Your Twins Apart

twins-birthmarks

Birthmarks are persistent areas of discolored skin that are generally visible from birth. While many birthmarks are permanent, some fade with time.  In general, birthmarks arise from either a concentration (or lack) of pigmentation or from a concentration of blood vessels in or just below the skin.

Strawberry Mark

A Hemangioma is a bright red raised area that can occur anywhere in the skin.   It might be barely noticeable at birth and then grow to an inch or several inches across during a child’s first months.  Because a hemangioma brings a blood supply to the surface of the skin, they may bleed easily if bumped or scratched.

Often when the child is 6 to 12 months old, the redness will fade to gray and the mark will flatten and fade in a process know as involution.  In some cases the skin might break down and erode during involution.   Strawberry marks often disappear by the time the child is 5 years old.  Strawberry marks on the scalp are often hidden by hair and require no treatment.  A hemangioma near an eye or on the face is often treated more aggressively.  Read more about Hemangiomas and Strawberry Marks here.

There are two main types of hemangiomas:

  • Strawberry hemangiomas (strawberry mark, nevus vascularis, capillary hemangioma, hemangioma simplex) may develop several weeks after birth.
  • Cavernous hemangiomas (angioma cavernosum, cavernoma) are similar to strawberry hemangiomas but they are deeper.

Port Wine Stains

A port wine stain is a hemangioma of dilated capilaries, and generally presents as a large red or purplish spot that occurs on the arm, leg or face.   It is sometimes raised and generally persists throughout adulthood.  Some port wine stains are associated with Sturge-Weber syndrome, so check with your pediatrician.    Port Wine stains often respond well to laser treatment which can soften the discoloration and provide cosmetic benefits.

Mongolian Spots

Mongolian spots are flat marks of various sizes that are present at birth and resemble bruises on the lower back or buttocks.  The spots are bluish greay to bluish green.

Cafe au lait spots

Cafe au lait spots are flat, irregularly shaped small tan or brown areas present on the skin at birth.

Capillary Marks

Capillary marks are small pinkish brown or pink spots present at birth that gradually fade away before a child is 18 months old.