Melanoma on the Scalp

Six percent of melanomas develop on the scalp and neck but are responsible for 10% of all deaths resulting from the disease.

The specific reasons for this remain unclear, but the scientific community does have a couple of hypotheses. In most patients, abnormal moles and skin growths are hard to see because they’re covered by hair. Also, there are more blood and lymph vessels located beneath the scalp than there are anywhere else on the body. Additionally, skin cancer on a person’s scalp has a short route to his or her brain.

What Does it Look Like?

Most appear as a brownish or black spot with darker irregular colors and borders. Although most are dark, some can appear as a firm pinkish red lump. Any previously existing mole or skin growth that changes in size, texture or appearance should be considered a huge red flag.

These 3 photographs all depict melanoma of the scalp:

 

 

 

 

Are There Ways to Improve the Chances of Discovering it?

Yes, there are. When doing your monthly skin self-exam use a long-handled mirror in combination with a well-lighted wall mirror. Use a hairbrush or dryer to part the hair. Be thorough. Spend the same amount of time checking under your hair as you do on all the rest of your body, combined. If you are unable to check your scalp, ask a close friend or significant other to check for you.

Ask your barber or hair stylist to alert you if he or she should notice any out-of-the-ordinary marks while cutting your hair. They’re not doctors, of course. But if something odd is discovered, a person can then quickly make an appointment with a dermatologist to have it checked out properly.

It sounds awkward, and unfortunately that can make people reluctant to ask their hairdressers to do it. That should be of absolutely no concern. It is a totally reasonable request that has become far more commonplace to workers in the industry. Some will even tell their clients if they find anything whether they initially asked them to or not.

Be sure to ask your doctor, or a nurse, to check each time you make a routine appointment. (This is in addition to what is stated above, as most people don’t see their primary care physicians monthly). Ask, because doctors typically don’t go out of their ways to look for skin cancer unless they either notice something obvious, or it’s related to the appointment.

*Additional source article: EmaxHealth.com

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

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Desmoplastic Melanoma

Desmoplastic melanoma is an uncommon type of melanoma, “in which the malignant cells are surrounded by fibrous tissue.”*

It’s most often diagnosed in pale-toned Caucasian men who are of advancing age, or who are elderly. In New Zealand, (which along with Australia sits atop the list of countries with the highest overall prevalence of skin cancer) desmoplastic melanoma accounts for around 1% of all melanomas. That percentage is likely comparable to its rate of occurrence within the United States.

As one might expect, overexposure to the sun’s harmful UV (ultraviolet) rays is the primary culprit in the development of desmoplastic melanoma. It’s another result that illustrates why the continual practice of sun-safety is so vital to everyone.

Unfortunately, the appearance of this form of melanoma doesn’t conform to the ABCDE signs  created by dermatologists to help the public know what to look for during their monthly skin self-exams.

That being the case, it’s important to have some idea of what skin growths to be wary of when checking for desmoplastic melanoma. To that effect, presented here are 3 photographs that depict a few of its various looks:

 

 

 

 

Of course, 3 pictures cannot tell the whole story of any disease. So, in a quote from the cited Derm Net New Zealand article, this is what to pay attention for:

“The most frequently observed dermoscopic features of desmoplastic melanoma are:

  • Features of melanocytic lesion in 50% (pigmented globules or network)
  • Asymmetrical structure and colours
  • Regression features: scar-like areas, grey dots
  • Multiple colours
  • Atypical or polymorphous vascular pattern”

Just like with traditional melanoma, desmoplastic melanoma is first dealt with by being excised and biopsied in order to determine the extent of any damage that has been incurred.

*Additional source articles: Dermnetnz.org, Skincancer.org (ABCDE information)

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

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Spitz Nevus: Mistaken Melanoma in Children

Potentially fatal melanoma is an ugly disease, both literally and figuratively. But it is important to know that it does have several ugly, benign “mimics” that may look similar, yet aren’t harmful.

One such mimic is called Spitz nevus, which sounds scary but is nothing more than an uncommon, seldom cancerous mole that develops primarily in children, adolescents and young adults.

Unfortunately, it can be so close in appearance to melanoma that even a highly-experienced dermatologist may not be able to distinguish whether the mole is cancerous without a biopsy and pathology report. And sometimes even that may not even be enough to confirm a malignancy.

As a result, most doctors and dermatologists won’t make assumptions or take any chances until melanoma is confirmed or ruled out.

Some physicians are not so diligent, however. So, if during your monthly skin self-exam you’ve discovered a new mole, or a previous one, that has changed its color, size, shape- or has bled or oozed, see a dermatologist as quickly as possible. It is vital that you don’t play around with your skin’s health.

At the Melanoma Education Foundation, we fully understand that very few people, if anyone at all, ever looks forward to an appointment with his or her doctor. But the indisputable fact of the matter is that, regarding skin cancer and especially melanoma, the speed of detection and treatment can and will in a very large part determine the difference between whether a patient lives or dies. That is not hyperbole, and it really is just that simple.

And, if an excised mole turns out to be nothing, the patient will gain both peace of mind and the removal of an unsightly skin growth. So, what is there to lose?

This is a photograph of a Spitz Nevus:

 

 

 

 

Additional source articles: Healthline.com

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

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

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Merkel Cell Carcinoma

Our skin cancer blog posts are nearly always focused on some variant of the potentially lethal melanoma. This post, however, will highlight an affliction much rarer and even deadlier- Merkel Cell Carcinoma (MCC).

Each type of skin cancer carries its own method of development and level of risk. One fact that remains consistent between all of them, however, is that the best chance for a successful outcome is the speed of diagnosis. Melanoma, the worst form of skin cancer, goes from nearly a 100% cure rate if caught earlier enough, to a painfully fatal disease if caught too late. But Merkel Cell Carcinoma is even more dangerous than melanoma, because its speed of growth is much faster.

When a person first notices a skin growth that turns out to be melanoma, there may still be time to stop it in its tracks. When he or she first glimpses MCC, it may already be too late. That’s why the focus should be on picking up on its warning signs, and early self-detection. Doing so will be effective in helping to stop MCC before it has a chance to really get started.

Patients should not wait for regular check-ups. Most doctors don’t even bother checking at all for skin cancer during routine exams unless they’re asked to, they notice something obvious, or there’s some specific reason to do so.

What to Look for

MCC typically presents as a painless skin growth that can be red, blue, purple or even match the color of the surrounding skin. The latter makes it much easier for people to make the crucial error of dismissing MCC as nothing more than a normal skin blemish.

Please note that MCC can easily be mistaken for nodular melanoma, or even a benign melanoma mimic.

AEIOU

For decades, dermatologists have touted the ABCD mnemonic device to remind the public how to look for melanoma during monthly skin self-exams. MCC has a similar, lesser known device, too: AEIOU, the 5 vowels in our alphabet placed in alphabetical order. They stand for: Asymptomatic, Expanding Rapidly, Immune Compromised, Over 50 & UV-Exposed Fair Skin.

Risk Factors

MCC primarily develops in people who are at least 50 years old, those who’ve incurred significant sun exposure and persons whose immune systems have been compromised; such as that which occurs after contracting HIV. Otherwise, MCC takes a similar path, albeit much quicker, to the one melanoma does.

If allowed to metastasize and progress away from the skin, it will head for lymph nodes and other organs such as the lungs, brain, liver and/or bones. Upon arrival it will launch an attack that is difficult for the body, even with significant medical treatment, to successfully defend. If the treatment is unsuccessful, the impact of MCC will most likely result in the patient’s death.

These 3 photographs of Merkel Cell Carcinoma show just how nondescript this disease can look:

 

 

 

 

Additional source articles: Mayoclinic.org, Curetoday.com (Fall 2017, Vol 16, No. 4, author Tara Haelle), Mdedge.com

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

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Important New Information on Spotting Nodular Melanoma

A few decades ago, New York-based dermatologists created a simple, effective mnemonic device to help people remember what to look for when performing their monthly skin cancer self-examinations. How simple? It’s (now) just the first 5 letters of the alphabet: ABCDE. The letters stand for Asymmetry, Border, Color, Diameter and Evolving. Advances throughout medical science are perpetual however, and new findings will at times reveal that updates to previously-promoted public education need to be made. Skin Cancer is no exception, and this post will address one important educational update.

Nodular Melanoma

Nodular melanoma is the more dangerous of the two types of potentially lethal melanoma, radial and nodular. Even worse, it disproportionally affects children. 40%-60% of newly diagnosed melanomas in teens and preteens are nodular, compared to 20% in adults. (For more information on nodular melanoma, please click HERE to read our previous post on the subject).

Many people who look for nodular melanoma concentrate their focus on finding new or changing dark-hued, irregularly-shaped moles and skin growths, which is consistent with ABCDE. That is, it was– prior to a recent, vital change.

A Crucial Discovery from the Land Down Under

Australia and New Zealand have the world’s highest incidence of melanoma; their citizens are 5 times more likely to develop melanoma than U.S. citizens. This gives their medical scientists significant motivation to continually try and find new breakthroughs in the fight against skin cancer.

In 2003, the head of the Victorian Melanoma Service published a summary of the research done by noted dermatologist Dr. John W. Kelly. It focused on the inadequacy of the ABCD warning signs, and advocated for the addition of EFG (Elevated, Firm, Growing) signs of nodular melanoma.

This quote from the cited source article illustrates just how vital the results of Dr. Kelly’s research is in helping both doctors and patients identify nodular melanoma:

“Nodular melanomas were mostly symmet-rical (80%), with a regular border and of single colour (78%), the majority (55%) being amelanotic. They were also more likely to be elevated (90%), weeping, crusted or tender in comparison to SSM.* Nodular melanoma are mostly red or pink in colour and if present, pigmenta-tion is usually evenly distributed throughout the lesion. They are raised from the outset and grow progressively as a round nodule.”

Additionally, some nodular melanoma can actually be pale in color. Together, all of this means that people who apply only the ABCDE principles to skin lesions may very well mistake a deadly cancer for a common, benign skin blemish. That type of error can have fatal consequences.

Upon learning the details of Dr. Kelly’s research, the Melanoma Education Foundation (MEF) recognized their importance and immediately incorporated the EFG signs into its educational materials and website (skincheck.org).

The Cancer Council of Australia was slow to follow-up. But last month (October 2017) it finally changed its melanoma diagnosis guidelines for doctors. The new guidelines have been updated to include EFG warning signs in addition to the previous ABCD signs. It’s time for the U.S. to follow suit!

Please help us spread the word.

*“SSM” refers to the more common superficial spreading melanoma.

Additional source articles: Researchgate.net, Australian Broadcasting Corporation

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

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

More Tanning Salons Ignoring State Laws

Washington D.C. joins more than 40 states that have put laws in place to protect minors from the highly dangerous act of indoor tanning. While that is a good thing in theory, laws are useless when they’re not obeyed.

A study cited within the linked source article revealed that almost 40% of tanning salons flout state laws, and many do so with little-to-no consequences.

A Burning Issue

Salons allowing teens to tan is not only an illegal act in most states, it’s also a morally reprehensible one. Most teenagers don’t have a complete understanding of the numerous hazards that tanning has on their health. And many who do are willing to take their chances in order to placate their vanity. It’s no great revelation that minors don’t always utilize the best judgement, which is exactly why these laws must be enforced regardless of the cost to a salon’s bottom line.

Tanning significantly increases the risk of developing skin cancer or, even worse, melanoma. The fact is that more people get skin cancer from tanning than get lung cancer from smoking. That statistic is staggering, and tanning salon owners know it. They also know that most of their young clientele don’t.

Salons promote tanning beds as peaceful, innocent diversions that make you look and feel great. These shysters are the present-day Marlboro Men. They’re projecting a harmful product as safe, while counting on the ignorance of youth to swell their coffers.

If a bar or store were to be caught selling alcohol or cigarettes to a minor, it could very well lose its license while the person who sold it loses his or her job. Law enforcement takes this issue seriously, as it should. Police routinely set up stings to discourage the practice and to keep businesses on their toes. Such stings should also be expanded to include indoor tanning salons. Unfortunately, tanning doesn’t yet have the same stigma attached to it that smoking does. It should though, because it can be just as dangerous.

Perhaps in time and with increased education tanning salons will go the way of cigarette machines and smoking sections. We can only hope. But what about the countless lives that will be disrupted or lost between that time and this?

This isn’t like the 1960’s prior to the Surgeon General’s smoking proclamation. We already know far too much about the dangers of tanning to be this passive. Skin cancer is the most common cancer in the world, yet it continually flies under the radar while taking a back seat in both funding and prestige to other diseases.

It’s time to get serious about enforcing existing tanning laws and holding salon owners accountable. By doing so, we can help prevent the destruction of countless young lives.

*Additional source articles: Health.usnews.com

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

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Melanoma Mimics

Few health-related issues cause greater instantaneous anxiety and fear than suddenly discovering something new and unsightly on our skin. After the initial shock, it’s human nature for most people to immediately start thinking about worst-case scenarios.

However, there‘s no need to panic or jump to conclusions. The reason is that there are many scary-looking, yet benign, skin growths and blemishes that only mimic the appearance of melanoma. But that determination is not something anyone should ever try to make on his or her own, or through research on popular self-help, diagnostic-focused healthcare websites.

Either through visual inspection or biopsy, only a dermatologist is sufficiently trained to distinguish which skin issues may be cancerous and which are not. As time is of the essence with regard to diagnosing melanoma, any suspicious looking changes to the skin should be brought to the attention of a dermatologist as quickly as possible.

A Look at Some Look-Alikes

To better illustrate the appearance of mimics, we’ll present six photographs of common skin conditions that have been mistaken for melanoma.

 

 

 

Solar Lentigo

These are more commonly known as age or liver spots. They’re benign, caused by sun exposure and primarily seen in older individuals.

 

 

 

 

Seborrheic Keratosis

Often found on middle-aged or older adults, they’re benign, develop as black, tan or brown in color and look like they’ve been pasted on. Black seborrheic keratoses may occasionally be a sub-type of melanoma, and have the potential to degenerate into squamous cell carcinoma.

 

 

 

 

 

Blue Nevus

Benign and, aside from their blue/black appearance they’re no different from any other ordinary mole, and have no greater potential to turn cancerous.

 

 

 

 

Dermatofibroma

These benign brown-to-red/purple growths are often caused by minor injuries, splinters or insect bites. They’re usually found on the arms and legs.

 

 

 

 

Keratoacanthoma

This common skin tumor originates within hair follicles, and is considered to be a low-grade squamous carcinoma.

 

 

 

 

Pyrogenic Granuloma

This benign blood-containing overgrowth may appear on skin or mucous membranes.

It’s important to remember that even if what’s been discovered is diagnosed as melanoma, if it’s caught and treated early enough this potentially lethal disease has nearly a 100% cure rate. So, if something on your skin doesn’t look right, get it checked out right away.

*Additional source articles: Melanoma Education Foundation (MEF) Fall 2015 newsletter

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

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Oral Melanoma

Oral melanoma is a rare type of melanoma. Most melanoma development is triggered by unprotected skin exposure to natural and artificial UV (ultraviolet) light. Oral, however, is not among the melanomas caused by UV rays. It’s a type of mucosal melanoma, which develops within mucus membranes. Areas within which mucosal melanomas are found include:

  • Respiratory tract
  • Nasal cavity
  • Sinuses
  • Oral cavity
  • Gastrointestinal tract
  • Transitional zone of anal canal (the line where normal skin meets the mucous membrane)
  • Genitourinary tract
  • Female genitals

Additionally, oral melanoma accounts for 1% of all melanomas, and is most common in Asians. 80% of it occurs in the palate and upper gums. It usually affects those who are over 40 years old and is rare in people under 20. Its color ranges from dark brown to blue-black, but 5-35% can be white, red or mucosa-colored. Oral melanoma is more aggressive than other oral cancers, as well as cutaneous melanomas.

Currently, medical science cannot pin down the exact cause(s) of oral melanoma, though it does have theories as to some potential ones. Among these are dentures, tobacco use and exposure to environmental chemicals.

What Should I be Looking Out For?

DermNet New Zealand provides a convenient list of what to keep an eye out for with regard to oral melanoma:

  • Discoloration in the mouth
  • Painless bleeding lump
  • Ulceration
  • Ill-fitting dentures
  • Nasal obstruction
  • Nose bleeds
  • Loss of smell

How Does it Compare to Typical Melanoma?

Like typical melanoma, oral melanoma can be cured if it’s diagnosed and treated quickly enough. However, that’s usually not the case. Oral melanoma is initially asymptomatic, so the issue is that it’s often unnoticed, ignored or simply dismissed as nothing of consequence.

As a result, by the time many cases are diagnosed they’re already too far advanced. This underlines the importance of being aware of the symptoms and what to look for.

These photographs depict 3 different manifestations of oral melanoma:

 

 

 

 

Oral squamous cell cancer is much more common than oral melanoma and is much more serious than squamous cell cancer on the skin.

The bottom line is to include your mouth during self-skin exams and see your dentist or dermatologist if you notice a bump, discoloration (including white), or anything unusual.

*Additional source articles: Dermnetnz.org, https://www.ncbi.nlm.nih.gov, oralcancerfoundation.org

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

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Age Spots and Melanoma

If you’re a nonmedical layperson, you know them as age spots, sun spots or liver spots. If you’re a doctor, they’re solar lentigines or actinic lentigines. Whatever you call them though, while visually unappealing most age spots are benign (safe/noncancerous). They can start to appear as early as a person’s 40’s, usually on the face, neck and backs of hands.

However, some develop into a form of in situ (in place) melanoma called lentigo maligna. From there between 5 to 20% of lentigo malignas can further develop into the invasive lentigo maligna melanoma, over the course of a 5 to 20-year span. On its own, lentigo maligna doesn’t pose much risk. But it becomes far more hazardous if a melanoma forms inside of it.

Most age spots and melanomas are created by the same source, natural and artificial UV (ultraviolet) rays. And while both may also have similar visual characteristics, there is an enormous difference between them.

People with age spots can try to diminish them through a wide variety of cosmetic procedures if they wish. Or, if they can tolerate their appearance on their skin, they can just leave them be and suffer no adverse medical consequences.

Melanoma, conversely, must be diagnosed and treated as quickly as possible after it has been discovered. The timing of treatment can easily mean the difference between life and death.

These points are important to remember because it can be difficult for even a trained professional to determine what is or is not melanoma just by looking at it. That’s why what you may assume to be an age spot should be checked out by a dermatologist if it is changing, or showing any of the ABCD warning signs. If it turns out to be nothing, fine. But for the sake of your health it’s always a step worth taking.

These 3 photos, from left to right, depict examples of age spots, lentigo maligna and lentigo maligna melanoma:

 

 

 

 

*Additional source articles: DermNet New Zealand, Livestrong.com, DermNet New Zealand (Same source, separate article)

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

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

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