Forms and symptoms of melanoma

There are four classical growth forms and special forms of melanoma. All melanomas follow the ABCD rule in their irregularity. According to this rule the contour (asymmetry), limitation, color (coloring), and size (diameter, > 5mm) are judged.

Symptoms may include itching and spontaneous bleeding. The four classical growth forms are described below. Superficial spreading malignant melanoma (SSM) Primary nodular malignant melanoma (NMM) Lentigo-maligna melanoma (LMM) Acrolentiginous malignant melanoma (ALM)

Superficial spreading malignant melanoma (SSM)
Primary nodular malignant melanoma (NMM)
Lentigo maligna melanoma (LMM)
Acrolentiginous malignant melanoma (ALM)

(superficial = superficial, malignant = malignant) As described above, melanomas in their initial phase follow a horizontal growth (growth in width) within the epidermis.

This growth phase lasts about 5 to 7 years, i.e. relatively long, which is why the early detection rate is constantly increasing. More and more early forms, the so-called “melanoma in situ”, are being discovered with a relatively good prognosis. The “melanoma in situ” represents an increased growth of melanocytes within the epidermis.

This growth is accompanied by the development of atypical cells. The morphology (appearance) of superficial spreading malignant melanoma (SSM) is very variable.It ranges from light brown to brownish-black and is initially a flat hearth, which in the further course of time shows nodules or knots. An immune reaction is present in the lighter areas of the tumor. The relative frequency of this clinical picture is 65%, whereby areas of the skin that are often exposed to the sun (e.g. face) are particularly affected. The mean age of the disease is about 50 years.

Primary nodular malignant melanoma

(nodular = nodular, malignant = malignant) This melanoma form seems to be more aggressive, because here the vertical growth phase into the depths begins immediately. The primary nodular malignant melanoma (NMM) consists of a fast – within months – growing node, which is mostly dark brown – black, often with a piebald pattern. The melanoma cells form this nodule in the dermis.

In the epidermis (epidermis) there are hardly any tumor parts to be found. The relative frequency of this clinical picture is 15%. As in superficial spreading malignant melanoma (SSM), sun-exposed areas of the skin are particularly affected. At 55 years of age, the mean age of the disease is also close to that of superficial spreading malignant melanoma (SSM).