Melanoma

Melanoma is a malignant tumor that originates from melanocytes, the pigment-producing cells of the skin. It is one of the most aggressive cancers, but with early detection and treatment, the chance of cure is high. Melanoma can develop on a pre-existing nevus (mole) or on normal skin.

Risk factors
- Intense exposure to UV radiation (especially burns in childhood)
- Fair skin, blonde/red hair, blue eyes
- Multiple (over 50) melanocytic nevi
- Atypical (dysplastic) nevi
- Family history of melanoma or other skin tumors
- Immunosuppression
- Genetic syndromes (e.g. familial atypical nevus syndrome)

Clinical forms of melanoma
- **Superficial spreading melanoma** – the most common type, often on the trunk and extremities
- **Nodular melanoma** – a rapidly growing tumor form, with an increased risk of metastasis
- **Lentigo malignant melanoma** – often on the face of older people
- **Acral lentiginous melanoma** – on palms, soles, under nails, more common in people with darker skin types
- **Amelanotic melanoma** – lack of pigment, difficult to recognize

Symptoms – ABCDE criteria
The ABCDE rule helps to recognize suspicious skin lesions:
A – Asymmetry
B – Border (Irregular borders)
C – Color (Heterogeneous pigmentation)
D – Diameter (Diameter >6 mm)
E – Evolution (Changes over time – size, shape, color, itching, bleeding)

Diagnosis
- Dermatoscopy – visualizes specific structures of the lesion
- Digital tracking in patients with many nevi
- Surgical excision of the suspicious lesion with histological examination (gold standard)
- Immunohistochemistry if needed
- Staging (TNM) for proven melanoma – imaging studies, tumor markers, sentinel lymph node biopsy

Treatment
**Surgical treatment:**
- Excision with a safe margin according to thickness (Breslow index)
- Sentinel lymph node biopsy for melanomas >1 mm or other risk features

**Systemic treatment (for advanced forms):**
- Immunotherapy (anti-PD1, anti-CTLA-4)
- Targeted therapy (BRAF/MEK inhibitors in BRAF mutation)

Forecast
The prognosis depends on the stage at diagnosis:
- Melanomas less than 1 mm thick and without metastases – excellent prognosis
- Deeper tumors and metastatic forms – progression and need for systemic therapy
- Early detection through preventive examinations significantly increases survival rates

Melanoma is aggressive, but preventable and treatable when diagnosed early. Awareness, self-monitoring, and regular check-ups are key to reducing mortality from this serious disease.