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MOLES, MELANOMA and SKIN CANCER

MOLES, MELANOMA and SKIN CANCER. Mary C. Martini, MD, FAAD Associate Professor Dermatology Director, Melanoma and Pigmented Lesion Clinic Northwestern University. MOLES. Everyone gets moles They can get bigger and darker due to sun burns and heavy sun exposure

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MOLES, MELANOMA and SKIN CANCER

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  1. MOLES, MELANOMA and SKIN CANCER Mary C. Martini, MD, FAAD Associate Professor Dermatology Director, Melanoma and Pigmented Lesion Clinic Northwestern University

  2. MOLES • Everyone gets moles • They can get bigger and darker due to sun burns and heavy sun exposure • Some families make “atypical” or irregular moles

  3. MOLES

  4. MOLES • Benign or healthy moles • Irregular moles-”dysplastic” • Melanoma

  5. Dysplastic Nevus • Multicolored • Asymmetric pigment deposition • Asymmetric contour-macular and papular • Indistinct margins

  6. Atypical mole syndrome-(Dysplastic nevus syndrome) • >100 melanocytic nevi • 1 or more nevi >8mm in diameter • 1 or more dysplastic nevi on exam

  7. Atypical Mole Syndrome has a 10 year risk of developing melanoma of 14% Wang et al.JAAD 2005;50:15-20

  8. Management of the Dysplastic Nevi Patient • Close monitoring- full body exams every 6 months • Dermoscopy of all atypical appearing nevi • Whole Body Photos • Excision of any changing or markedly atypical nevi

  9. Body Mapping Studio • positioning stage • indexed monostand • balanced cross-lighting • high resolution digital camera • body mapping software

  10. The Body Map

  11. At Home Exam

  12. Dermoscopy • The magnified visualization of pigmented skin lesions beyond what would be visible by the physician • Increases diagnostic accuracy by 10-20% Dermlite.com

  13. Benign Nevireticulated pattern

  14. Dysplastic Nevi

  15. Dysplastic Nevi • Asymmetric pigment pattern • Irregular depigmentation • Irregular edge

  16. Melanoma

  17. Melanoma

  18. Changes in Overall Cancer Mortality (1975-2000) • Prostrate -5% • Breast -15% • Colorectal -25% • MELANOMA +28%

  19. Melanoma

  20. Melanoma

  21. Tumor Thickness- Breslow level Level 5yr survival <0.75mm 97.9% 0.76-1.49mm 91.7% 1.5-3.99mm 72.8% >4mm 57.5% Barnhill et al,Cancer 1996

  22. Incidence of melanoma • 1900 - 1 in 2000 • 2004 - 1 in 70 • Major cause is ultraviolet exposure

  23. Tanning bed use before the age of 35 increases the risk of skin cancer by 75%

  24. SUN DAMAGE

  25. PHOTOAGING • Sun damage • Pollution • Heredity

  26. LENTIGOS • “Sunspots or big freckles” • Increase in size and color with more sun exposure • Areas with these growths may be areas that develop skin cancer years later

  27. Lentigo

  28. Lentigo

  29. Photodamage

  30. Actinic Keratosis

  31. SKIN CANCER • Basal cell carcinoma • Squamous cell skin cancer • Melanoma

  32. Basal Cell Carcinoma • Most common skin cancer • Never metastasizes • Sun damage is the major cause

  33. Basal Cell Carcinoma

  34. Basal Cell Carcinoma

  35. Squamous Cell Carcinoma • Second most common form of skin cancer • Can metastasize if neglected and continues to grow • Sun damage plays a major role

  36. Squamous Cell Carcinoma • Can occur in preexisting burn and traumatic scars • Can occur on lower lip due to smoking or chewing tobacco in addition to actinic damage

  37. Squamous Cell Carcinoma

  38. Benign Lesions

  39. Warts • Caused by a virus • Spread by shedding skin • Treated by “cryo”, 5FU or salicylic acid plaster -oral/genital warts linked to cervical and oral/throat cancer

  40. WARTS

  41. Angiomas

  42. Seborrheic Keratosis

  43. Dermatofibromas

  44. Sebaceous Hyperplasia

  45. SUNSCREENS • Facial everyday sunscreens SPF 15-25: Eucerin facial, Oil of Olay facial, Purpose • Chemical free- titanium dioxide and zinc oxide- Blue Lizard and Neutragena • Waterproof sunscreens SPF 35-70: Coppertone sport, Neutragena with helioplex, Blue lizard, in Canada or Europe sunscreens with Mexoryl • Reapply every 2 hours if swimming or sweating

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