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Published on : Feb 24, 2014
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Slide 1 - MOLES, MELANOMA and SKIN CANCER Mary C. Martini, MD, FAAD Associate Professor Dermatology Director, Melanoma and Pigmented Lesion Clinic Northwestern University
Slide 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
Slide 3 - MOLES
Slide 4 - MOLES Benign or healthy moles Irregular moles-”dysplastic” Melanoma
Slide 5 - Dysplastic Nevus Multicolored Asymmetric pigment deposition Asymmetric contour-macular and papular Indistinct margins
Slide 6 - Atypical mole syndrome-(Dysplastic nevus syndrome) >100 melanocytic nevi 1 or more nevi >8mm in diameter 1 or more dysplastic nevi on exam
Slide 7 - Atypical Mole Syndrome has a 10 year risk of developing melanoma of 14% Wang et al.JAAD 2005;50:15-20
Slide 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
Slide 9 - Body Mapping Studio positioning stage indexed monostand balanced cross-lighting high resolution digital camera body mapping software
Slide 10 - The Body Map
Slide 11 - At Home Exam
Slide 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
Slide 13 - Benign Nevireticulated pattern
Slide 14 - Dysplastic Nevi
Slide 15 - Asymmetric pigment pattern Irregular depigmentation Irregular edge Dysplastic Nevi
Slide 16 - Melanoma
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Slide 18 - Melanoma
Slide 19 - Changes in Overall Cancer Mortality (1975-2000) Prostrate -5% Breast -15% Colorectal -25% MELANOMA +28%
Slide 20 - Melanoma
Slide 21 - Melanoma
Slide 22 - 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
Slide 23 - Incidence of melanoma 1900 - 1 in 2000 2004 - 1 in 70 Major cause is ultraviolet exposure
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Slide 25 - Tanning bed use before the age of 35 increases the risk of skin cancer by 75%
Slide 26 - SUN DAMAGE
Slide 27 - PHOTOAGING Sun damage Pollution Heredity
Slide 28 - 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
Slide 29 - Lentigo
Slide 30 - Lentigo
Slide 31 - Photodamage
Slide 32 - Actinic Keratosis
Slide 33 - SKIN CANCER Basal cell carcinoma Squamous cell skin cancer Melanoma
Slide 34 - Basal Cell Carcinoma Most common skin cancer Never metastasizes Sun damage is the major cause
Slide 35 - Basal Cell Carcinoma
Slide 36 - Basal Cell Carcinoma
Slide 37 - Squamous Cell Carcinoma Second most common form of skin cancer Can metastasize if neglected and continues to grow Sun damage plays a major role
Slide 38 - 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
Slide 39 - Squamous Cell Carcinoma
Slide 40 - Benign Lesions
Slide 41 - 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
Slide 42 - WARTS
Slide 43 - Angiomas
Slide 44 - Seborrheic Keratosis
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Slide 47 - Dermatofibromas
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Slide 49 - Sebaceous Hyperplasia
Slide 50 - 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
Slide 51 - Skin Cancer Prevention Skin protection involves use of sunscreens including reapplication Wear sun screen containing clothing and hats Avoid prolonged sun exposure from 11 am to 3 pm
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