Malignant melanoma is a dangerous, life-threatening tumor that may be unnoticed in older age. Its nodular form may mimic a mole or seborrheic keratosis. It may be a flat, irregularly colored lesion on the palm or sole, or present under the nail in pigmented or unpigmented form. This condition has received much attention from cancer prevention authorities as an overlooked life-threatening lesion. Self inspection, or inspection by a family member, or a care-giver is promoted.
A mnemonic has been developed that suggests immediate skilled medical assessment if
A for Asymmetry. . . one half being unlike the other half is present
B for a Border which is irregular, being either scalloped or poorly circumscribed
C for Color, which varies from one area to another; there may be shades of tan or brown, black, or sometimes red or blue
D for a Diameter larger than six millimeters, the size of an average pencil eraser.
There are other cancerous conditions that are much less dangerous. Basal cell carcinoma is quite common. Its origin likely lies in light exposure during childhood and adolescent years, but it may present only in later life, as a small, pearly nodule barely visible to the naked eye. Enlarged surface blood vessels may be present about its edge. It grows slowly and asymptomatically, doubling its size each year. It can ulcerate, and in that form is known as a rodent ulcer. Less often it is flat, pigmented, or cystic. Though it rarely metastasizes, it can erode locally, and for that reason should be removed.
Squamous cell carcinoma is ten times less common than the basal cell carcinoma. It is an irregular, scaling, fairly well-defined lesion most commonly found on the face, lips, or back of the hand. Sometimes it is fairly flat, but at other times it is heaped up and craggy. It can metastasize, particularly when it is on mucous membrane, such as the lips. For that reason, early recognition and management are important.
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