Symptoms
Melanomas are discolored, growing, skin lesions that arise from pigmented moles in about 30% of cases. They are found primarily on the skin, but can occur anywhere melanocytes are found, including the oral mucosa, respiratory tract, or eye, for example. In men they are most common on the upper body, in women on the legs. This is due to the different clothing behavior. They are most common in older people over 50, but can also occur in younger people and children.
Risk factors
- UV exposure and sunburn (especially in childhood). Possibly solarium visits.
- People with a fair skin type, ie with fair skin, blue eyes, freckles, blond or red hair.
- People with many or atypical pigmented moles (nevi, birthmarks). On the one hand, melanoma can arise directly from existing pigmented moles (about 30%), on the other hand, pigmented moles are a marker for the disease.
- People with melanoma in the family
- People with a history of melanoma
Primary prevention
Sun radiation (UV radiation) and sunburn are risk factors for the development of melanoma, so these rules of conduct should be followed:
- Avoid sun exposure, especially between 11 am to 3 pm.
- Wear protective clothing: headgear with neck protection, long sleeves and pants.
- Wearing sunglasses
- Sunscreen (UV filter) with a protection factor adapted to the skin type. The factor should always be higher than 15.
- Protect children from sunburn.
- In any case, a visit to the solarium is not recommended.
Although UV radiation is a known risk factor for the development of melanoma, to date it has not been fully proven scientifically that, conversely, avoiding radiation can actually reduce the incidence of melanoma: “There is, as yet, no direct evidence that reducing sun exposure has had an effect on melanoma incidence” (Bataille et al., 2008) “Scientific and epidemiological evidence that regular use of sunscreens can prevent the development of cutaneous malignant melanoma is lacking.” (Cummins et al., 2006) Nevertheless, it is recommended to reduce UV exposure.
Secondary Prevention
Suspicious pigmented moles on the body can be identified by simple rules, even by the layman. For this purpose, the pigment moles are examined with the help of the ABCD rule. They have the following characteristics:
- A Asymmetry: irregular, non-symmetrical shape.
- B Boundary: irregular, fuzzy edges.
- C Color (color): different colored, blotchy.
- D Diameter and dynamics: changes in size, color, shape, thickness.
Suspicious pigmented moles should be examined by a dermatologist or dermatologist. People with risk factors (melanoma in the family, many or atypical pigment moles) should also have an annual medical examination.
Treatment
Under medical treatment. Melanomas are surgically removed by excision. In metastatic melanoma, chemotherapy, such as with dacarbazine, may be necessary. New and specific drugs have been approved in recent years: Kinase inhibitors:
- Binimetinib
- Cobimetinib
- Dabrafenib
- Encorafenib, with binimetinib
- Trametinib
- Vemurafenib
Monoclonal antibodies / cancer immunotherapy:
- Ipilimumab
- Pembrolizumab
- Nivolumab
Oncolytic viruses:
- Talimogenlaherparepvec
