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TYPES OF MELANOMA
Superficial Spreading
70% of all Melanomas
Spreads along surface, before
invading deeper
Irregular shaped, flat or elevated,
multiple colors
Trunk, legs and upper back -
most commonly involved areas
Lentigo Maligna
Older age group
Very early Melanoma, with a good
prognosis
Face, upper trunk and arms
Nodular
Black nodule, usually invading
deeply
Acral
Found on the palms of hands,
soles of the feet and under the nails
Desmoplastic
Lacks pigment and can be a very
aggressive Melanoma
INCIDENCE
Highest in fair skin individuals
& those with sun exposure
PROGNOSIS
Pathological Classification by depth of penetration
into the skin
Clark's levels of penetration
Level I - confined to Epidermis
Level II - penetrates the upper
dermis or Papillary layer
Level III - fills the upper
dermis or Papillary layer
Level IV - penetrates the lower
dermis or Reticular layer
Level V - invades deeply into
the fat
Breslow's Classification based on
Invasion Depth into the Skin
TREATMENT
Surgical excision - wide, based on
the depth of penetration
1-2-3 Rule
Remove a 1cm cuff of normal
tissue on all sides of the Melanoma for penetration 1mm or less
Remove a 2cm cuff of normal
tissue on all sides of the Melanoma for penetration 2mm or less
Remove a 3cm cuff of normal
tissue on all sides of the Melanoma for penetration greater than
2mm
Sentinel Lymph Node Removal or Lymphadenectomy
Biopsy of lymph node(s) - First
dye is injected into the skin surrounding the Melanoma to find the
lymph node drainage. Then the 1st node in the chain is removed and
analyzed
Lymphadenectomy (removal of
all lymph nodes in the area) is done if there is involvement of
the Sentinel node(s)
Radiation Therapy ( generally done
to relieve tumor symptoms )
Chemotherapy ( systemic or local
- used to control tumor spread )
Biological or Immunotherapy
Agents used to stimulate
the Immune System
Block blood vessel
formation
Directly attack
the tumor cells
BCG ( Bacillus-Calmette-Guerin,
TB strain ) or Vaccine
Interleukin 2 ( Lymphokines
)
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Melanoma Skin Cancer Thousand Oaks Skin Cancer Thousand Oaks, Beverly Hills, Los Angeles, Encino, Calabasas, Camarillo, Ventura. Doctor Christopher Costanzo MD, Skin Cancer Surgeon performs skin cancer removal and reconstruction for Melanoma, Basal Cell Carcinoma, Squamous Cell Carcinoma and other skin cancers for men and women in Thousand Oaks, Beverly Hills, Los Angeles, Encino, Sherman Oaks, Woodland Hills, Tarzana, West Hills, Canoga Park, Chatsworth, Calabasas, Westlake Village, Thousand Oaks, Oxnard, Moorpark, Simi Valley, Camarillo, Ventura and Santa Barbara. |
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