Melanoma is the 5^th most common cancer in United States, with approximately 16,000 new cases per year – and increasing at the rate of 2% per year. Melanoma leads to the most common skin cancer-related deaths, and current data indicates that lifetime risk in the general population is 2% for children born today.

There are several risk factors that are responsible for the development of melanoma, with UV exposure being the most important. Melanoma skin cancer risk is 16-25% higher in people with history of sun exposure or sunbed abuse. Skin phenotype also seems to play an important role with Fitzpatrick I & II involving a greater risk than the others. The presence of moles/nevi seems also to influence the probability of melanoma development.

There is also a correlation between geographic location and melanoma risk. More specifically, those in higher altitudes and lower latitudes have increased UV exposure, and therefore increased risk of melanoma. Furthermore, African-Americans, despite their skin phenotype and the lower rates of incidence, have the worst prognosis due to delayed diagnosis. Family history or a personal history of previous incidences melanoma also increase the risk.

Diagnosis is mainly based on physical examination through the mapping of moles/nevi. Common clinical features include asymmetry, border irregularity, color variation and/or presence of ulceration. If there is a clinical suspicion, an excisional biopsy is performed.

The prognosis varies depending on the location (trunk lesions generally carry a worse prognosis than those on the extremities, Breslow thickness, and staging (stages III/IV have the worst prognosis).

The treatment of melanoma ranges from surgical excision up to lymph node dissection and even post-operative oncological treatment, depending always on the pathological anatomical characteristics of the biopsy.

Prevention is mainly based on avoiding risk factors, such as excessive sun exposure, as well as on self-examination and the mapping of moles.

*Dr. Rammos is a plastic surgery specialist at the General Hospital of Athens ‘Gennimatas’. This clinic has the largest melanoma referral center and burn unit in Greece and it handles oncological, reconstructive, and burn cases. The above article was written special for The National Herald.