Lentigo melanoma is considered a rare, but very aggressive, variant of dermatological pathology. Only 5-10% of all cases of diseases on the skin of oncological origin are in this form
In most cases, the occurrence of lentigo melanoma does not occur spontaneously. Pathology is transformed from Duban melanoma.
Pathology development
At the initial stage, lentigo melanoma looks harmless. It does not cause any inconvenience to the patient.
Melanoma is a small spot whose color may be yellow, brown or brown. Its size does not reach more than 2.5 cm in diameter. In some cases, the tumor looks like a black ball located in the center of the brown spot. The boundaries of the tumor are clear, the spot itself is irregular in shape, but without seals and nodes. Their appearance marks the later stages of the pathological process.
At the initial stage, lentigo melanoma grows in the horizontal direction. In the future, the spot shows growth in vertical projection. In most cases, melanoma appears on exposed areas of the skin, including the face, arms, neck, and chest in the décolleté area. It is much less commonly found on the legs, heels, or hands.
Causes
According to statistics, women are twice as likely to develop malignant lentigo melanoma as men. However, in males, the disease progresses in a more aggressive form. The age of patients who have undergone the appearance of lentigo is in the range of 50-60 years. A tumor of this type can occur in any person, however, people with fair skin who are sunbathing with burns and whose body has many age spots are most susceptible to this pathology.
Fundamental to saving the patient’s life is the fact that the malignancy is slowly growing. The progression of pathology can occur over many years and even decades. According to oncologists, the pathological process can last from 21 months and reach 30 years. The main reason for the development of this type of melanoma is experts consider trauma to benign neoplasms. In addition, the following factors are also highlighted:
- Obtaining a significant amount of exposure to ultraviolet rays. And we are talking about both regular trips to the solarium, and about a long stay in the sun.
- Excessive dryness of the skin and its prolonged stay in a dehydrated state.
Symptoms
The main sign of incipient melanoma is the appearance of a neoplasm in the form of a spot. In addition, it can provoke the appearance of scars. The following symptoms should be noted:
- Asymmetry.
- Surface roughness formation.
- Itching
- Swelling.
In the early stages of the development of the disease, as a rule, pain is absent. At later stages, lentigo melanoma is characterized by the appearance of metastases, which affect the lymph node system. At this stage, additional symptoms are added, namely:
- Dizziness.
- Weakness.
- Temperature increase (insignificant).
- Swelling of the lymph nodes. Axillary nodes are most often affected.
The sooner a person discovers signs of melanoma, the higher the chance of recovery, so delaying going to the doctor is not recommended.
Diagnostics
Modern medicine allows you to diagnose malignant lentigo melanoma even at the very early stages of its development. Pathological changes can be detected through several diagnostic procedures:
- Inspection It should be carried out by a specialist in the field of dermatology and oncology. In the process of visual inspection, a specialist can use various devices and tools to enlarge the image. A preliminary diagnosis can be made based on the size and appearance of the formation. A similar examination method is also called dermatoscopy.
- Blood test. Allows you to determine the presence of enzymes that are characteristic for the appearance of melanoma.
- Morphological study. It is carried out by taking part of the affected tissue or even the entire neoplasm. Accumulations of melanocytes, inflammatory processes in the dermis, and also dystrophy of the skin are considered indicators of melanoma.
- Multiple biopsy. The collection of material for the study comes from various sites of the neoplasm. An incisional biopsy is performed in cases where melanoma has actively grown and reached large sizes.
A histology of lentigo melanoma is also performed.
Histological examination reveals reactive growths of the epidermis in the form of pronounced acanthosis and thickening of the epidermis, which occur in response to the intraepidermal nature of tumor growth.
Differential diagnosis
Differential diagnosis helps not to confuse pathology with actinic lentigo or hyperkeratosis. The latter is similar to melanoma, but is benign in nature. As a diagnostic method, a potential biopsy is performed. As for actinic lentigo, it is also benign, however, has the form of plaques and occurs in the same areas of the skin as melanoma. In this case, differential diagnosis is carried out through research on tumor markers.
Treatment
The effectiveness of the therapy depends largely on the stage of the pathology, the extent of skin lesions and the presence or absence of metastases. The most commonly used treatment for melanoma is surgery. Unlike many other surgical procedures, the introduction of general anesthesia is far from always required in the case of melanoma. With a small education, the operation is performed under local anesthesia. During the course, her specialist completely removes the neoplasm along with some healthy dermis around. This is done in order to avoid relapse of the disease in the future.
If melanoma has arisen in open areas of the skin, including on the face, some time after the operation, a cosmetic procedure is allowed to eliminate the defects that have arisen. If metastases spread along the lymphatic flow, lymphadenectomy is performed, suggesting the elimination of the affected lymph nodes.
Another way to treat lentigo melanoma is with close-focus radiotherapy. The procedure involves sending x-rays to the affected area of the skin. The treatment method is highly accurate. Another advantage of the procedure is the absence of damage to healthy areas of the skin. With the help of X-rays, it is possible to suspend the activity of the development of pathology, but not completely cure it.
The treatment of any cancer involves the use of chemotherapy and radiation therapy. Vitamin therapy and immunostimulation play an equally important role in the treatment of melanoma.
Lentigo melanoma prognosis
The prognosis of this disease is unfavorable. The lethal outcome, as a result of the active metastasis of this type of melanoma, is more than 75%. Every year, approximately 92 thousand cases of this disease are recorded in the world.
Prevention
It is impossible to completely prevent the appearance of melanoma, but there is a way to reduce the likelihood of its development at times. To begin with, it should be remembered that the appearance of any neoplasm on the skin is a reason for seeking medical attention. If there is a genetic predisposition to cancer or education shows a tendency to degenerate, it is removed at the stage of a benign tumor.
People with fair skin should avoid exposure to open sunlight without protective creams. Campaigns in the solarium are also best limited or abandoned altogether.
Lentigo melanoma is a serious disease. Do not hesitate or delay with treatment. Her regression is a rather rare phenomenon, but a lethal outcome due to lentigo is common.