Melanoma: Causes, Recurrence, and Prevention Tips

What is melanoma?

Hello Dr.
Luo:
1.
Why do melanocytes develop into melanoma under the nails?
2.
If a finger is amputated, does recurrence start from the lymphatic system and then spread throughout the body?
3.
If it is detected in the early stages, what kind of health care should be followed or what books should be purchased for further reading? Thank you very much for your guidance.

Yuequan, 40~49 year old female. Ask Date: 2002/04/09

Dr. Luo Qihua reply Plastic Surgery

1.
Melanoma can develop in any area of the body that contains melanocytes, including the eyes and beneath the nails.
It can arise from normal moles that undergo long-term irritation, from the natural evolution of congenital giant nevi, from prolonged exposure to ultraviolet radiation from sunlight, or it may occur without any identifiable cause.

2.
The metastasis of melanocytes primarily spreads along the lymphatic pathways.
Therefore, if there are lesions on the fingers, it is important to monitor for any enlarged lymph nodes in the corresponding axilla.
Even after the surgical removal of a finger, one should regularly check for changes in the axillary region.
3.
I apologize, but I am not aware of any specific books available for reference, and there may not be any dedicated publications on melanoma currently on the market.
It is crucial to have follow-up appointments every three months initially, then extend the interval to every six months to a year.
If any unusual pigmentation occurs near the amputation site, or if there are unusual limb pain and hard lumps in the axilla, it is important to return to the doctor promptly for evaluation to check for possible metastasis, in order to avoid delays in treatment.

Reply Date: 2002/04/09

More Info

Melanoma is a serious form of skin cancer that arises from melanocytes, the cells responsible for producing melanin, which gives skin its color. Understanding the causes, recurrence, and prevention of melanoma is crucial for effective management and treatment.

1. Causes of Melanoma: Melanoma can develop in various parts of the body, including under the nails (subungual melanoma). The exact cause of melanoma is not fully understood, but several risk factors have been identified. These include excessive exposure to ultraviolet (UV) radiation from the sun or tanning beds, having fair skin, a history of sunburns, and a family history of melanoma. Genetic factors also play a significant role; individuals with certain genetic mutations, such as those in the CDKN2A gene, are at higher risk. Additionally, the presence of atypical moles or a large number of moles can increase the likelihood of developing melanoma.

2. Recurrence of Melanoma: After the surgical removal of melanoma, the risk of recurrence can vary based on several factors, including the thickness of the tumor, whether it has spread to lymph nodes, and the overall health of the patient. If melanoma recurs, it can indeed spread through the lymphatic system to nearby lymph nodes and potentially to distant organs, leading to metastatic melanoma. Regular follow-up appointments with a healthcare provider are essential for monitoring any signs of recurrence. Patients are often advised to perform self-examinations of their skin and report any changes to their healthcare provider promptly.

3. Prevention and Health Maintenance: For individuals diagnosed with early-stage melanoma, several preventive measures can be taken to reduce the risk of recurrence. These include:
- Regular Skin Checks: Regularly examining your skin for any new moles or changes to existing moles is crucial. Dermatologists recommend performing self-exams monthly and having professional skin checks annually.

- Sun Protection: Protecting your skin from UV radiation is vital. This includes wearing sunscreen with a high SPF, seeking shade, and wearing protective clothing and hats when outdoors.

- Healthy Lifestyle: Maintaining a healthy diet, exercising regularly, and avoiding smoking can contribute to overall health and may help reduce the risk of cancer recurrence.

- Education: Reading books and resources about melanoma can provide valuable information. Recommended titles include "The Melanoma Book" by Dr. John M. Kirkwood and "Melanoma: A Patient's Guide to Diagnosis, Treatment, and Survival" by Dr. John D. Thompson. These resources can help patients understand their condition better and empower them to take an active role in their health care.

In conclusion, understanding melanoma, its causes, and the importance of monitoring and prevention can significantly impact outcomes for patients. If you have specific concerns or symptoms, it is essential to consult with a healthcare professional who can provide personalized advice and treatment options. Regular follow-ups and education about the disease are key components in managing melanoma effectively.

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