Malignant melanoma Presented by Mo. Haroon Rashid

These presentation is a short presentation of malignant melanoma and presented by Mo. Haroon Rashid in Florence College of Nursing Limtara Dhamtari

1. Malignant Melanoma By Mo. Haroon Rashid

2. Introduction Melanoma is a very serious from of skin cancer. Melanoma is cancer of the melanocytes. Melanocytes are located in the stratum basale and produce melanin. When skin is exposed to sunlight melanocytes produce more pigment, causing the skin to tan. Sometimes, clustera of melanocytes form noncancerous growths called moles.

3. Introduction malignant melanoma can spread through both the bloodstream and lymphatic system and can metastasize to the bones, liver, lungs, CNS and lymph nodes. A malignant melanoma is a malignant neoplasm in which atypical melanocytes are present in both the epidermis and the dermis. It is the most lethal of all skin cancers. It can occur in one of several forms. Melanoma is a type of  skin cancer  that originates from the cells in  the skin  responsible for  pigmentation ( colour ) , known as melanocytes. 

4. Definition According to “Ross and Wilson” Melanoma is a type of skin cancer that originates from the cell in the skin responsible for pigmentation,Known as melanocytes. Melanoma can occur in adults of children in rare case present in at birth. According to “ Dr.Imtiyaz Wani ” Melanoma is a most dangerous or serious type of skin cancer, develops in the cells (Melanocytes) that poroduce melanin the pigment that gives your skin its colour . Mealnoma can also form in your eyes and rarely in internal organs such as your intestines.

5. INCIDENCE Although melanoma accounts for only about 5% of all skin cancer cases, it causes most skin cancer related deaths. The incidence is rising by 3%. About 96,480 new melanomas will be diagnosed (about 57,220 in men and 39,260 in women). About 7,230 people are expected to die of melanoma (about 4,740 men and 2,490 women). The rates of melanoma have been rising for the last 30 years.

6. TYPES OF MALIGNANT MELANOMA

7. 1.Superfecial Spreading Melanoma The cells tend to grow slowly at first, before spreading across the surface of the skin . Superficial spreading melanoma  is a type of  skin cancer  that slowly grows horizontally across the top layer of skin before moving to the deeper layers. It's the most common form of  melanoma , accounting for 70 percent of all cases

8. 2.Nodular Melanoma Nodular melanoma  is a type of  skin cancer . It's a dangerous form of  melanoma  that grows quickly. Only about 15% of all  melanomas  are  nodular . But it causes nearly half of  melanoma -related deaths. So you need to know the sign.  It tends to grow more quickly than other types, turning red—rather than black—as it grows.

9. 3.Lentigo Malignant Melanoma This is less common, and tends to affect older people, especially in parts of the body that have been exposed to the sun over several years . Lentigo maligna melanoma  is a  melanoma  that has evolved from a  lentigo maligna . They are usually found on chronically sun damaged skin such as the face and the forearms of the elderly. The nomenclature is very confusing to both patients and physicians alike.

10. 4.Acral Lentiginous Malignant This is the rarest kind of melanoma. It usually appears on the palms of the hands, soles of the feet, or under the nails . Acral lentiginous melanoma  (ALM) is a specific type of  melanoma  that appears on the palms of the hands, the soles of the feet, or under the nails. Melanocytes contain your skin color (known as melanin or pigment). In this type of  melanoma , the word “ acral ” refers to the occurrence of the melanoma  on the palms or soles.

11. Causes of Malignant Melanoma

12. 1.Sun Exposure Ultraviolet (UV) rays are an invisible form of radiation. They can pass through your skin and damage your skin cells. Sunburns are a sign of skin damage

13. 2.Personal History Of Skin Cancer

14. 3.Excessive Ultraviolet light exposure Exposure to UV radiation, which comes from the sun and from tanning lights and beds, can increase the risk of skin cancer, including melanoma.

15. 4.Weakened Immune System People with weakened immune systems, such as those who've undergone organ transplants, have an increased risk of skin cancer.

16. 5.Fair Skin Having less pigment (melanin) in your skin means you have less protection from damaging UV radiation. If you have blond or red hair, light-colored eyes, and freckle or sunburn easily, you're more likely to develop melanoma than is someone with a darker complexion. But melanoma can develop in people with darker complexions, including Hispanics and blacks.

17. Pathophysiology

18. Sign and Symptom

19. 1. Change skin in afeected Part

20. 2. Skin Sore

21. 3. Pain in Affected part

22. 4. Redness of Affected Area

23. 5. Development of Blister in Affectd Part

24. Stages of Malignant Melanoma

25. Stag - 0 In Stage 0 melanoma, the malignant tumor is still confined to the upper layers of the skin.  This means that the cancer cells are only in the outer layer of the skin and have not grown any deeper. The term for this is  in situ , which means “in place” in Latin. There is no evidence the cancer has spread to the lymph nodes or distant sites (metastasis).

26. Stag - 1 Stage I melanoma is defined as a melanoma that is up to 2mm thick.  A Stage I melanoma may or may not have ulceration. There is no evidence the cancer has spread to lymph nodes or distant sites (metastasis).

27. Stag - 2 Stage II melanoma is defined by tumor thickness, and ulceration.  There is no evidence the cancer has spread to the lymph nodes or distant sites (metastasis). 

28. Stag - 3 Stage III melanoma is defined by the level of lymph node involvement and ulceration.  In Stage III melanoma, the depth of the melanoma no longer matters. There is no evidence the cancer has spread to distant sites (metastasis)

29. Stag - 4 Stage IV melanoma occurs when the melanoma has spread beyond the original site and regional lymph nodes to more distant areas of the body.  The level of LDH (serum lactate dehydrogenase) may or may not be elevated. The most common sites of metastasis are to vital organs (lungs, abdominal organs, brain, and bone) and soft tissues (skin, subcutaneous tissues) and distant lymph nodes (lymph nodes beyond the primary tumor region).

30. Complete blood Count Chest Radiography MRI CT Scan Biopsy History Taking Physical Examination Diagnostic Evaluation

31. Complete blood Count Chest Radiography MRI CT Scan Biopsy History Taking Physical Examination Diagnostic Evaluation

32. A – Asymmetric B - Border C – Colour D – Diameter E – Evolving Diagnostic Evaluation

33. Management of Malignant melanoma

34. Medical Management Chemotherapy is an aggressive form of chemical drug therapy meant to destroy rapidly growing cells in the body. It’s usually used to treat cancer, as cancer cells grow and divide faster than other cells. A doctor who specializes in cancer treatment is known as an oncologist. They’ll work with you to come up with your treatment plan.

35. 2.Radiation Therapy Radiation therapy (also called radiotherapy) is a cancer treatment that uses high   doses  of  radiation  to kill cancer  cells  and shrink tumors. At low doses, radiation is used in x-rays to see inside your body, as with x-rays of your teeth or broken bones.

36. 3. Biological Therapy Biological therapy boost immune system to help body fight cancer. These therapy is improve the body immune system and fight the against of cancer. These therapy is used to treatment of Malignant melanoma.

37. Wide Excision :- Excision simply means “to cut out.” Surgical excision can be used to treat  melanoma  and  non-melanoma skin cancer . Excision is also called “wide excision.” This is because the tumor is cut out together with some of the healthy skin around it. The healthy skin is called a margin. The reason for taking a margin is to remove any  cancer cells  that have spread into the surrounding tissue. Surgical Management

38. Mohs Surgery Mohs surgery is a precise surgical technique used to treat skin cancer. During Mohs surgery, thin layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains. Mohs surgery is also known as Mohs micrographic surgery. The goal of Mohs surgery is to remove as much of the skin cancer as possible, while doing minimal damage to surrounding healthy tissue. Mohs surgery is usually done on an outpatient basis using a local anesthetic. Surgical Management

39. Avoiding excessive exposure to ultraviolet radiation can reduce the risk of skin cancer. Avoiding sunburn Wearing clothes that protect against the sun Using sun screen with a sun protection. Protecting children by keeping them in the shade with clothing and by applying sun screen. To maintain body ability. Nursing Management

40. Scarring Pain Infection of skin Skin Necrosis Lymphoedema Chronic pain wound Complication

41. Thank you All of You