Melanoma Does Not Discriminate: The Story of Jacqueline Smith

One of the more difficult tasks when educating the public about melanoma, is helping to dispel the notion that it’s a “whites only” disease. While it’s true that whites are statistically much more susceptible to melanoma, it can develop in any person from any race.

What’s also not widely known is, for various reasons, while whites are more likely to get melanoma, once contracted blacks are more likely to die from it. Black people also have a greater tendency to develop melanomas in areas that don’t often see the sun. These places include beneath toenails and fingernails and on the soles of feet. A famous example of this is popular Reggae singer Bob Marley, who died at age 36 from a melanoma that began on his big toe.

To help illuminate these points, we’re going to share the story of Jacqueline Smith, a young black woman from New Jersey whose story was chronicled by writer Kellee Terrell (cited below).

 

 

 

 

 

Jacqueline Smith

Her tale begins the same unfortunate way that the tales of too many melanoma patients do. She found a skin growth that was misdiagnosed -in her case twice- by two different doctors. This highlights the importance of seeing a dermatologist rather than a general practitioner after a suspicious skin growth is discovered. With melanoma, the speed of diagnosis and treatment means everything. And a dermatologist has much greater training and experience with skin cancer than a regular doctor does.

Fortunately, Jaqueline didn’t let it go. Upon returning home from college she got a third opinion. This time, the doctor sent her to an oncologist (a doctor whose specialty is cancer) where tests determined she had Stage 3 melanoma.

Jacqueline relates that her initial reaction to learning of her diagnosis was nearly identical to what we’ve described in our opening paragraph. She thought melanoma (skin cancer’s most lethal form) was exclusive to whites. She recalls that in grade school she was told not to bother with sunscreen, because her skin tone made sunscreen unnecessary.

A surgeon excised Jacqueline’s cancerous lymph node, but within three years her cancer returned to give her the fight of her life. She underwent more surgery and was subjected to exhaustive treatment. Her odds weren’t good. But now, a decade later, she’s beaten those odds on her long-term prognosis by 5 years.

Jacqueline still has concerns that her cancer may return one day, but they’re not slowing her down.

Like many people who experience melanoma either first-hand, or through a cherished relative or friend, she was inspired to help others learn the truth about the disease. She’s focusing on the black community, and is working hard to dispel the myth that melanoma only impacts whites.

We wish this brave young woman continued success with all of her educational efforts.

*Information source article: “Black Woman Shares Skin Cancer Survival Story: ‘Please Don’t Think It Can’t Happen To You’”, an article written by Kellee Terrell, contributing writer to Hellobeautiful.com

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

A Melanoma Menu

There is a lot to learn about melanoma. On the surface, it’s a fairly-straightforward subject; yet it’s also one that carries with it many important subtopics. This piece consists of selections from our previously published posts on the subject.

To view the original Melanoma Education Foundation (MEF) article on any of the topics below, simply click the link and you’ll be brought directly to it.

From Bad to Worse

About Radial and Nodular Melanoma, the two primary forms of the worst skin cancer.

A Bad Match: Keeping Moles Away from the Sun

The reasons why exposing moles to sunlight is a very bad idea.

Ginger Ail

A discussion on the increased risk of melanoma to redheads.

Connecting the Dots

For those with many moles, there is a tool that dermatologists can use to help keep tabs on patients’ skin health.

Which is Which?

How to tell the difference between freckles and moles

Normal and Abnormal Moles

Differentiating between normal and atypical moles.

Your Chances of Developing Melanoma

A discussion of melanoma risk factors.

Checking Up on Yourself

How to examine yourself for early signs of melanoma.

Skin Cancer: Not Child’s Play

The differences and similarities between childhood melanoma and melanoma in adults.

Melanoma: A Color-Blind Cancer

Information on Acral Lentiginous Melanoma, which is more common in blacks, Hispanics and Asians than it is in whites.

Stage 0 Melanoma

The best form of the worst skin cancer.

The Eyes Have It

Ocular Melanoma is a rare, deadly cancer that is not caused by UV (ultraviolet) ray exposure.

Can You Identify the Bad Guys?

A quick visual quiz that tests your ability to tell benign moles from those that are cancerous.

Action, Not Fear

What to do if a suspicious growth is found during a skin self-examination.

Survey Says?!

The excellent results from teachers who were surveyed regarding the effectiveness of the Melanoma Education Foundation’s (MEF) classroom melanoma lessons.

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Mole Mapping

If you have high skin cancer risk factors, or those who have over 50 moles, or too many moles to easily track yourself, mole mapping is a useful tool. Even better, the procedure is non-invasive and completely painless.

How Does Mole Mapping Work?

A dermatologist will take pictures and images of his or her patients that encompass the outer layer of skin. Once completed the records are archived. They’re then used later to check against future images and monitor any newly-developed moles; along with any changes to pre-existing ones.

This photograph depicts a patient undergoing mole mapping with her dermatologist:

It’s Not a Catchall

Research into mole mapping has revealed that it does increase the chances that dermatologists will discover early melanomas. (In one study, the odds increased by 17%).*

However, mole mapping should be used to augment, not replace, a person’s skin health care behaviors; as it has its limits. For instance, melanoma can develop on the scalp, which for most people is covered with hair that the cameras can’t see through. It can still miss cancerous moles, and there is always the possibility that a melanoma will develop and spread quickly during the time-gap between office visits.

For those reasons, it’s also important to perform monthly skin self-examinations, so any oddities can be brought swiftly to the attention of a dermatologist.

Working in tandem, skin self-exams and mole mapping will provide an even greater chance of catching and stopping a melanoma before it’s too late.

How do I Locate Dermatologists Who Provide Mole Mapping?

If you or someone you know is interested in mole mapping and would like to find local offices that perform it, start by running an internet search for “mole mapping services, ZZ”. When you do, simply replace the “ZZ” with your state’s postal abbreviation. (For example, Wyoming = WY, Minnesota = MN, etc.)

*Additional information sources: News-medical.net/health/Mole-Mapping.aspx (Catherine Shaffer, M.Sc.)

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

SPF: Fact versus Fiction

Each day, more people learn about the importance of wearing sunscreen whenever they’re outdoors to shield themselves against the sun’s harmful UV (ultraviolet) rays. While that news is heartening, getting that information out is only half of the battle.

If a user misunderstands how a sunscreen’s Sun Protection Factor (SPF) works, or if the product is incorrectly applied, the level of protection received can be considerably lower than he or she believes it to be. That can be very dangerous.

Here’s why:

If your mouthwash contained a lesser percentage of cinnamon flavor than you thought it did, it would make absolutely no difference as far as your health is concerned. However, if you walked around every day thinking you were wearing a sunscreen that provided more skin defense than it actually did, that mistaken notion could end up resulting in skin cancer. Or, even worse, the potentially deadly melanoma.

Don’t Get Burned, Either Literally or Figuratively

We’d like to help clear up this confusion. There is a view held by many that, because an SPF 50 sunscreen absorbs 98% of UVB radiation while an SPF 100 sunscreen absorbs 99%, just 1% more, the SPF 100 sunscreen offers hardly any advantage over the SPF 50 sunscreen. That’s a misinterpretation of the facts.

If an SPF 100 sunscreen is correctly applied and continually re-applied every two hours at a minimum, (or immediately after swimming or profuse sweating) it’ll provide adequate skin protection for double the amount of time that a SPF 50 sunscreen will.

But Wait, There’s More!

There are other ways that we inadvertently end up leaving ourselves vulnerable to those dangerous UV rays. We’ll go over a few here.

It’s the rare person who applies an amount of sunscreen sufficient enough to reach the SPF level touted by the product. And, whether they do or not, most don’t re-apply it as needed- if they even re-apply it at all.

Every time you use sunscreen, the goal should be to cover every sun-exposed inch of skin. If you’re in a swimsuit, the necessary quantity is enough to fill a shot glass. In fact, instead of guessing, consider simply using an actual shot glass.

Unfortunately, independent studies have shown that an alarming number of sunscreen brands don’t meet the SPF ratings that their packages trumpet. It’s important to do a little online research on your favorite brand to see if the claimed SPF is accurate.

Finally, it bears repeating. You’ve probably heard that famous real estate slogan, it’s all about location, location, location! With sunscreen, think re-application, re-application, re-application! If you’re going to be spending time outdoors, re-application is as important as applying sunscreen is to begin with.

*Additional source: Melanoma Education Foundation (MEF) Fall 2016 Newsletter

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Melanoma Risk Factors

There’s no question that a primary trigger in developing skin cancer (and its most lethal form, melanoma) is unprotected exposure to the sun’s ultraviolet (UV) rays. However, there are some factors that can increase our susceptibility. Some of them are within our control, and, unfortunately, some of them are not.

Regardless, it’s still vital to be aware of both, as knowing these risks are there will make us more likely to pay closer attention to our skin. Catching melanoma early enough can easily mean the difference between life and death.

There’s a famous old saying that applies so well to skin cancer, its’ author could very well be referring specifically to it: Knowledge is power.

We’re here to provide some of that knowledge today, with the hope that you’ll help us spread it far and wide.

What Can’t I Control Regarding Melanoma?

Right up front, we’d like to clarify a popular misconception that skin cancer is strictly a Caucasian disease. Believing that incorrect notion can turn out to be a huge mistake. Any human being of any ethnicity can develop melanoma.

With that said, melanoma does play favorites. Whites have the greatest risk at about 1 in 44. In descending order, they’re followed by Hispanics (1 in 250), Native Americans (1 in 350) Asians (1 in 800) and Blacks (1 in 1,100).

The following uncontrollable risk factors for melanoma are grouped together based on their amount of risk:

Characteristics that increase melanoma risk by a factor of 2-4:

  • One atypical mole
  • 50 or more normal moles
  • Heavily freckled with no atypical moles
  • Green or blue eyes, blond or red hair
  • Parkinson’s Disease

(Click HERE for more information on atypical versus normal moles)

Characteristics that increase risk by a factor of 9 or more:

  • 10 or more atypical moles
  • Personal history of melanoma
  • If two or more immediate family members have had melanoma, or if you are heavily freckled and one immediate family member has had melanoma, you have a 100% chance of getting it
  • Specific skin diseases, including Lupus and Xeroderma Pigmentosum, carry a high but undefined risk
  • Photosensitizing medication or treatment increases the risk, but the degree has yet to been determined

What Can I Control Regarding Melanoma?

Depending on your current age, some of these points may have already passed you by. If at one time any of them applied to you, it’s important to keep an extra-sharp eye out when doing your monthly skin self-examinations. Those who are in the two highest risk categories should have a dermatologist examine them every six months at minimum. Due to their skin-specific medical training, dermatologists are more adept at diagnosing skin cancer than general practitioners are:

  • Unprotected intermittent skin exposure to sunlight during any season of the year, in any climate
  • A single blistering sunburn under age 20 doubles the risk; 3 or more increase it 5 times
  • One use of a tanning bed under age 35 ups the odds nearly 1¼ times, while 10 or more uses under age 30 elevates the risk nearly 8 times

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Freckles versus Moles

The name of this week’s skin cancer blog post may sound a bit like the title of a Grade B movie.  However, it’s actually a reference to a common confusion between the two titled skin conditions that we very often come across. Hopefully, this piece will help to alleviate any confusion.

Freckle Facts

To help illustrate the differences, we’re going to provide some of the most useful information to have regarding freckles and flat moles. We’ll begin with the most important fact. Unlike flat moles, true freckles lack any cellular structure, which makes it impossible for any of them to turn cancerous. So if that’s ever in any way been a worry to either you or someone you know, you can put it out of your mind.

 With that said, here are some answers to a few more freckle FAQ’s. A mole can be flat, raised or partially-raised. They’re often secluded on our skin, and when not they’re part of an irregular grouping of other moles. By contrast freckles, which are simply clusters of melanin (our natural skin pigment), are without exception always flat.

Unlike some moles, freckles are never present at birth. They present later, after sun-exposure, to people who are predisposed to getting them. Moles are usually darker than freckles, with the latter susceptible to lightening in the winter and darkening during the summer months. To literally illustrate the difference, here are photos of both. The left picture depicts flat moles, and the right one, freckles: 

 

 

 

 

 

We’d kindly ask you to keep one thing in mind. While freckles by themselves are totally harmless, having them usually means having a light complexion and/or sun-damaged skin. As such, extra care should be taken in the form of monthly self-examination of your skin, and meticulous sunscreen use whenever you’re outdoors.

*Additional source: Melanoma Education Foundation (MEF) Newsletter (Spring 2013)

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

MEF’s Focus on Education Over Research

When we began the Melanoma Education Foundation (MEF) in 1999, we briefly considered throwing our support to the research side of skin cancer. However, we ultimately concluded that for us specifically, the best way to make a difference was to focus exclusively on melanoma education. We’ve maintained that focus for over 18 years, and the results of our efforts continually prove that we made the right decision.

Why Education?

The MEF was created by our founder after he suffered the tragic loss of his son Dan to melanoma at 26 years of age. As we began reaching out to other victims of this disease and their families, we quickly became aware of a few very disheartening truths. Most melanoma patients possessed little-to-no knowledge about the affliction prior to developing it or, even worse, until it progressed too far to stop.

Moreover, we discovered that most middle and high school health and wellness educators were also uninformed about melanoma. As such, they don’t ever mention anything about it in their health classes. That is a huge opportunity lost, because the odds of developing melanoma skyrocket in our mid-20s. How can we expect children and adolescents to understand (or to simply be aware) of the risks associated with exposure to the sun’s harmful UV rays if they’re not provided with the information?

The Choice

Research is a short word with a chasm full of different definitions; particularly when it’s associated with medical science. We wanted to accomplish as much as possible with our limited finances, and we had a choice. We could’ve given our support to “research”, but to be honest what does that even mean? Does anyone who’s ever dropped a dollar into a store’s countertop jar to benefit a given disease know where that money goes? Or how much of that dollar will actually get to where it’s most needed? Sure, it feels good but there’s nothing tangible about it. You don’t even really know how much of a difference you’ve made, if any. Even worse, you’ll never know.

Like the legendary Jonas Salk, the medical scientist who rid the world of the scourge of Polio, sooner or later some group of scientists working for some massive pharmaceutical company are going to take down melanoma. But what if it’s later rather than sooner? And what about all the melanoma victims who’ll die in the meantime of a disease they could’ve easily avoided had they only known? What we could contribute to the development of new skin cancer medicines and technologies would be akin to tossing a Dixie Cup full of spring water into Lake Superior.

On the other hand…

What if, instead, we directed our attention to reaching teachers about the importance of melanoma education in the classroom? If successful we could make a tremendous difference through bypassing the post-acquisition treatments and cutting skin cancer off at its’ source.

There’s infinite wisdom in the old adage ‘An ounce of prevention is worth a pound of cure’. And over these last 18 years we’ve exceeded our greatest expectations. The melanoma lessons our website offers are now being taught in over 1,700 middle and high schools spread across 49 U.S. states.

What helps is that, as deadly as it can be, melanoma has a few vulnerabilities that are easy to exploit- and also easy to instruct others about. If caught early enough, a simple doctor’s office excision carries a 98% cure rate. And melanoma is one of the few potentially fatal diseases that loudly announces itself ahead of time with skin changes, blemishes and discolorations. These can then be found during a short, monthly skin self-examination.

We’ve taken numerous surveys and have had countless conversations. And we’ve heard time and time again from students, teachers and our website’s visitors that they’ve all found early melanomas they would not have paid any attention to were it not for their MEF education.

One day, melanoma will be swept away into the dustbin of medical history where it belongs…

…but until that joyous day comes, we will continue to honor Dan- and the millions like him -by aggressively working to deny skin cancer as many victims as we possibly can.

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Can Smartphone Apps Detect Melanoma?

Smartphones Preparing to Take on Skin Cancer

For thousands of years, humanity’s progress in the fields of medicine and technology moved along at a glacial pace. That lack of speed is now, quite literally, ancient history. Today’s scientists and physicians are making advancements, improving diagnostic instruments and developing new treatments at seemingly the speed of light. No sooner does one breakthrough occur than it’s quickly replaced by an even better, more effective one.

There is perhaps no greater cause for excitement than when new scientific technology is married to some aspect of medical science. And it appears that we may right now be on the cusp of another such achievement. It concerns the all-important early detection of potentially fatal melanoma; the deadliest form of skin cancer.

Can Smartphone Apps Detect Melanoma?

A group of scientists based out of California’s Stanford University have created an extraordinary smartphone app. It employs artificial intelligence that allows a smartphone to “view” uploaded pictures of moles and skin blemishes; and then determine whether they’re skin cancer. In ongoing trials the app has shown itself to be remarkably accurate.

Imagine the positive impact such a device would have for people who live in sparsely populated regions and areas without easy access to a dermatologist. Or those with low incomes and little-to-no medical insurance.

Theoretically, the app would inform its user if skin cancer or melanoma has been detected, and at that point he or she could quickly make a dermatological appointment. If a mole is benign, it saves the person from unnecessary travel costs and medical bills.

However, it’s important to note that the future has not yet arrived. As promising as this technology is, it’s not yet been perfected. In fact, two years ago the Federal Trade Commission (FTC) admonished both Mole Detective and Mel App for false advertising when neither company could offer scientific proof to substantiate their promotional publicity statements.

If you do decide to give this technology a try, an app like SkinVision will allow you to store multiple images of your mole or blemish. This allows users to chronicle any changes that can later be easily produced for their dermatologists. This is of a greater benefit than an occasional, self-visual observation.

Drawbacks

Unfortunately, it’s possible for even the most experienced dermatologist to be tricked into thinking a nodular melanoma is benign after a single visual appraisal. As such, it’s unreasonable to expect that a smartphone app will always provide a correct assessment after analyzing a single image.

Doppler: Not Just for Predicting Weather

Aside from the general anxiety caused by the thought of potentially receiving an unwanted diagnosis, many people put off scheduling skin exams due to an expectation that some element of pain will be involved. First, a routine skin exam is non-invasive. A doctor or dermatologist will look you over and, if necessary, use a special magnification instrument to check any suspicious moles up close.

When melanoma is suspected, the next step is to excise the affected area and have the tissue biopsied by a pathologist. However, Lancaster University scientists have created a new, painless way to test; best described in this direct quote from the cited ScienceDaily.com article:

Researchers have developed a new non-invasive technique which can accurately detect malignant melanoma without a biopsy. Their report shows that a special technique using a laser to detect the subtle differences in blood flow beneath the skin enabled researchers to tell the difference between malignant melanoma and non-cancerous moles.

The laser referenced is called a Doppler Laser.

Of course, nothing is better for our overall skin health than an examination by a fully-qualified dermatologist. But due to the vital importance of a quick skin cancer diagnosis, once ready these highly-convenient tools could turn out to be real life savers.

*Additional source articles: Health.good.is, Consumerist.com, CNN.com, ScienceDaily.com

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Squamous Cell Carcinoma

Squamous Cell Carcinoma

Unlike melanoma, Squamous Cell Carcinoma (SCC) (SQUAY-muss) is a fairly-common type of skin cancer that is not typically fatal. Just like melanoma though, if it’s left undiagnosed, it too can turn lethal.

Squamous Cell Carcinoma can originate in any of the body’s numerous squamous cells. You may not be too surprised to learn that those cells are where this form of skin cancer gets its name. As with many such cancers, its primary cause is overexposure of unprotected skin to the sun’s harmful UV rays.

It can also be developed after tanning bed use. As an aside, there are no words strong enough to sufficiently emphasize the importance of avoiding those beds. This also includes lamps used for things like securing gel nail polish. Any commercial use of artificial UV light is a 100% Risk-0% Reward activity. Any dermatologist will attest that that is not in any way hyperbole.

SCC usually develops on the areas of our skin that are most likely to incur unprotected sun exposure; such as on the scalp, ears, lips and the backs of hands.

How deadly it might become can also be determined by the area on which it begins. The mortality rate climbs when it’s located on the lips, in the mouth, over the carotid artery, or on skin covering internal organs such as the lungs.

As with melanoma, SCC can present with a variety of appearances. However, what it looks like most often is a slightly raised red patch that becomes rough, dry and scaly.

Presented below are two pictures. On the left is an example of SCC. The picture to its right depicts Actinic Keratosis, which we’ll discuss shortly:

 

 

 

 

SCC is generally a slow-growing skin cancer; except when it initiates on the lips or in body parts containing mucous membranes.

Here is a photo of SCC developing on lips:

 

 

 

 

 

Actinic Keratosis

Actinic Keratosis (AK) is a pre-cancerous lesion that takes decades to fully develop and rarely progresses to SCC. You’ve likely seen it many times on the middle-aged and, more particularly, the elderly.

At the risk of sounding like a broken record, AK, too, is caused by UV ray exposure.

Of course, these lesser-afflictions also serve to highlight just how many different forms of skin damage our sun can- and does -inflict upon us.

Currently there are multiple effective non-surgical treatment options for treating AK and early stage SCC. Among the most common of these is freezing them off.

One terrific way to avoid dealing with SCC, AK and every other skin cancer you’ve read about on our previous blogs, is to simply not get them to begin with. Protect your skin; protect your life.

*Additional source articles: Mayoclinic.org, Mayoclinic.org

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Skin Cancer Education Re-imagined

The Melanoma Education Foundation (MEF) has been making great strides throughout the United States with its middle and high school-focused skin cancer lessons. Our most recent figures show that they’re used in over 1,700 different schools; spread out over every U.S. state but one. We would very much like to keep that ball rolling. (A link to a list of those schools, as well as to actual teacher testimonials, are both provided below)

If you’re a pre-teen or adolescent health and wellness educator, we encourage you to review and present these highly-informative lessons to your classes. They are designed to be efficient, easy-to-use, and require virtually no prep work. Even better, they fit entirely into a single class period with plenty of time to spare.

Registration is easy and completely free. To do so, simply click right HERE and you’ll be directed to our melanomaeducation.net website. Both the short student and teacher-training videos you’ll receive post-registration access to have won the prestigious Gold Triangle Award from the American Academy of Dermatology. (AAD)

Now let’s go a little more in-depth into why these lessons are so valuable to both you and your students. Teacher surveys taken after in-class presentations of the MEF lessons reveal that due directly to them, many early melanomas were discovered by students, teachers and family members.

That is crucial, as in its earliest stages melanoma has a cure rate of nearly 100%. The more time that passes between its development and diagnosis, however, allows for the continual increase of the odds that it will become fatal.

The MEF high school lesson is currently the only one that specifically addresses nodular melanoma. Melanoma is the worst form of skin cancer, and nodular is the most lethal type of melanoma. Even worse, teenagers are particularly vulnerable to nodular, which unfortunately doesn’t typically show any of skin cancer’s familiar ABCDE signs. (A= Asymmetry, B= Border, C= Color, D= Diameter, E= Evolving)

MEF also differs from other skin cancer lessons by providing more comprehensive information, which in turn leads to more effective results. Most non-MEF lessons continue to direct their primary focus on sun-safety. They do this despite the plentiful data garnered from numerous studies that show emphasizing sun-safety has little-to-no effect on altering teen behavior patterns. In other words, teens essentially ignore it.

This approach also prevents teenagers from learning the critical fact that 30% of melanomas are not even caused by UV ray exposure. Among other risks, not having that knowledge may cause students who aren’t into tanning to skip regular skin-self exams; thinking they need not bother.

To all the health educators within sight of these words, please consider employing our lessons. The more schools that incorporate their usage, the more young lives we can all save together.

Please click to view a variety of teacher testimonials

Please click to view the list of schools using the MEF skin cancer lessons

To visit our websites, please click: skincheck.org and/or melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma