Could you have a melanoma?

Posted on 2 December 2021

Melanoma is a serious form of skin cancer that begins in cells known as melanocytes. Early detection could save your life.

“A melanocyte is a special cell within the top layer of the skin with the ability to produce pigment or melanin,” says Dr Jacques du Toit, a dermatologist at Mediclinic Louis Leipoldt. “These cells have an important function since the pigment protects the skin against harmful ultraviolet rays from the sun. Many melanocytes grouped together in the skin is referred to as a mole.”

Melanoma occurs when DNA damage from sunburn or tanning triggers mutations (changes) in the melanocytes, resulting in uncontrolled cellular growth. This form of skin cancer is dangerous because it can spread to other organs more rapidly if it’s not treated early.

One phone call from her dermatologist was all it took to change Jackie Labrecque’s life. Following her second pregnancy, a mole on her right arm had become darker and more irregularly shaped, eventually prompting her to seek medical attention. A biopsy revealed it was superficial melanoma. “I’m just so grateful it was diagnosed early,” Jackie says. “I had it surgically removed and have been religious about sun safety ever since – even on cloudy days.”

Dr Du Toit adds that melanoma can present in many different shapes and sizes. “Dermatologists use dermoscopy and mole mapping to diagnose melanomas early,” he explains. “Dermoscopy is a simple skin exam done with the help of a dermoscope, a small, handheld device that both illuminates and magnifies. This allows your dermatologist to see structures of the skin not visible to the naked eye.”

While most advanced melanomas can be detected when applying the ABCD and E criteria [link to infographic], melanoma can also present as pink (rather than dark brown or black) and can affect the sole of the foot or the toenails and fingernails. “Fair-skinned people are more at risk because they have less natural pigmentation or melanin to protect their skin against harmful ultraviolet rays,” Dr Du Toit explains.

 

The three main types of melanoma

1. Superficial melanoma is the most common form. It can appear in an existing mole or present as a new lesion.It’s most likely to appear on the torso (men), legs (women) and upper back. It may appear as a flat or slightly raised and discoloured, asymmetrical patch with uneven borders.

 

2. Nodular melanoma is the most aggressive type and often appears as a blue-black, pink or red bump on the skin. It’s a deep melanoma most frequently found on the torso, legs and arms, as well as the scalp in older men, and is usually already invasive at the time of diagnosis.

 

3. Acral melanoma often appears in hard-to-spot places, such as under the nails and on the soles of the feet or palms of the hands.

 

Dr Du Toit explains that treatment for melanoma includes surgical excision and removal of the affected lymph nodes. “In addition, modern, advanced immunotherapy activates the immune system to target the melanoma anywhere in the body. This treatment is more effective than chemotherapy,” he says.

 

INFOGRAPHIC: What you need to know about melanoma