Melanoma
Melanoma is a type of skin cancer that develops from melanocytes, which are the cells that produce pigment (melanin).
- Ultraviolet radiation like sunlight and tanning beds
- A history of sunburns
- Fair skin, light eyes, light hair
- Having many moles, especially if many are atypical
- Personal or family history of melanoma
- Certain genetic factors
- A suppressed immune system
Importantly, melanoma can occur anywhere on the skin, as well as in mucous membranes or the eyes. The most common site in women is the leg, and the most common site in men is the back. While it is more common in those with light skin that burns easily, it can occur in any skin tone, including people who rarely burn.
We tell patients to look for the “ugly duckling” – a spot that sticks out because it looks different from your other moles. We also recommend reviewing the ABCDE’s in terms of what to look for:
- A (Asymmetry): One half doesn’t match the other or is behaving differently
- B (Border): The lesion’s edges are poorly defined or irregular
- C (Color): Multiple colors or uneven pigmentation
- D (Diameter): Size >0.6 cm (1/4 inch)
- E (Evolving): Any change in size, shape, color, or symptoms (bleeding, itching)
For melanomas, the stage and specific pathology features are key to determining prognosis and treatment. Important details of the tumor include:
- Breslow thickness (how deep the melanoma is)
- Ulceration
- Mitotic activity
- Margins
- Lymphovascular or perineuralinvasion
- Sentinel lymph-nodestatus
- Whether thereis microsatellitosis or other evidence of spread
Treatment of a melanoma depends on the characteristics and stage of the tumor. It may include surgical removal of the melanoma, sentinel lymph node biopsy in certain cases, targeted therapy for melanomas with certain genetic changes or immunotherapy.
You should contact your doctor if you have a new or changing skin lesion that:
- Bleeds easily
- Does not heal within several weeks
- Changes in size, shape, color
Confirmation of the diagnosis is typically through a skin biopsy.
Board-certified dermatologist and double board-certified Mohs surgeon Dr. Patricia Richey specializes in the diagnosis and surgical treatment of skin cancer, including melanoma. She is widely regarded as one of the leading skin cancer surgeons in Chevy Chase, Bethesda, and the surrounding communities. Dr. Richey sees patients at her Chevy Chase office, serving individuals from Bethesda, Potomac, Washington, DC, and the surrounding areas.
At a Glance
Dr. Patricia Richey
- Board-certified dermatologist
- Fellowship-trained and board-certified Mohs surgeon
- Harvard fellowship-trained in lasers and cosmetics
- Author of innovative dermatology research and publications
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