- Compound nevus (with irregular border)
- Seborrheic keratosis
- Hemangioma
- Dermatofibroma (pigmented)
Prognosis
- Two most important determinants
- Tumor thickness
- Ulceration: present or not
- Recurrence/survival
- Sample sentinel lymph node
- 1st node in lymphatic basin that drains lesion
- Bx if depth of lesion >=1mm
Risk Factors
- Complexion (fair skin; red or blond hair)
- PHx
- Atypical nevus
- 1 lesion --> 2* risk
- >=10 lesions --> 12* risk
- Melanoma
- Non-melanoma skin cancer
- Congenital nevus >20cm diameter
70% are superficial-spreading melanomas and slow-growing
15% are nodular melanoma and fast-growing
Any changing skin lesion (pigmented or non-pigmented)
--> must consider melanoma
Stage
- Sample sentinel group of lymph nodes
- # affected
- Tumor burden within node
- FBC; LFTs; serum LDH
- CXR; ?CT chest?
- ?CT or MRI brain?
Rx
- Surgical
- Excision margin
- <1mm thick --> 1cm
- >=1mm thick --> 2cm
- Medical
- Interferon-alfa
- Improves outcomes in Stage IIB - IIIC
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