Melanoma

DID YOU KNOW?

Melanoma is a life-threatening type of skin cancer that develops in melanocytes, which produce skin pigment. It is one of the fastest-growing forms of cancer and can develop on the face and other parts of the body. It is widely accepted that excessive sun exposure can lead to serious health problems, including melanoma. Since significant sunburns during the first 18 years of life is believed to increase the risk of cancer by more than 50%, children are at risk. Also at risk are those with sensitive skin, fair complexions, and light hair. Excessive exposure can also lead to a higher risk of melanomas. The ABCDs of melanoma are as follows:

• asymmetry: when one half of the lesion appears different than the other
• border: when the borders are irregular, scalloped, or poorly defined
• color: whether brown, black, tan, red, white, or blue
• diameter: when larger than 6 millimeters (about the size of a pencil eraser)

WHAT IS IT?

Five percent of all skin cancers are malignant melanoma and roughly 66% of deaths from skin cancer are due to these growths. Most cutaneous melanomas appear to develop without a history of a nevus. There are four types of cutaneous melanoma: lentigo maligna melanoma, superficial spreading melanoma, nodular melanoma, and acral lentiginous melanoma.

WHO GETS THEM?

Primary malignant melanomas of the eyelid are very rare and account for about one percent of all eyelid cancers. The average American’s lifetime risk for developing a skin melanoma is 1:128.

WHERE DO THEY OCCUR?

Lentigo maligna, also known as Hutchinson’s melanotic freckle, is the premalignant lesion of lentigo maligna melanoma and represents 10% of all skin melanomas (common in the head and neck). These tend to be flat, tan to brown lumps, sometimes with areas of white and grey, and irregular borders. Most often, they occur on sun-exposed facial skin in the elderly.

Superficial spreading melanoma is considered the more common form of melanoma and accounts for 70% of skin melanomas. It usually involves nonexposed skin surfaces and grow faster than lentigo maligna.

ARE THEY DANGEROUS?

Malignant melanoma poses life-threatening risks.

TREATMENT

A patient with a suspected eyelid melanoma should be examined as soon as possible. An incisional biopsy to confirm diagnosis is important.

Removal and reconstruction are the pillars of treating malignant lesions. Mohs surgery is a common surgical procedure used for the treatment of skin cancers. The goal is to remove the cancer, minimize recurrence, and preserve as much healthy skin as possible. Depending on the extent of the cancer, reconstructive surgery may then be necessary.

At Idaho Eyelid & Facial Plastic Surgery, our surgeons are specifically trained in reconstructive oculoplastic surgery. We have extensive experience dealing with surgical management of tumors. A variety of these surgeries involve skin grafting and precise stitching. While some patients require a meticulous two-layered closure to ensure the lashes don’t grow in towards the eye as it heals, others may require skin grafting to ensure full closure of the wound. Patients should have realistic expectations about eyelid skin cancer, surgery, recovery, and scarring. A significant effort is always made to minimize scarring and obtain optimal cosmetic results. Follow-up appointments are critical to ensure skin cancer does not recur. Early detection and prompt treatment is imperative.