An iPhone App for Skin Cancer Diagnosis

A free app is the new coolest thing for DIY skin cancer diagnosis. As long as you're willing to take 23 nude photos of yourself.

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Symptoms of Melanoma

The most important warning sign for melanoma is any change in size, shape, or color of a mole or other skin growth, such as a birthmark. Watch for changes that occur over a period of weeks to a month. Use the ABCDE rule to evaluate skin changes, and call your health professional if you have any of the following changes.

A is for asymmetry. One half of the mole or skin growth doesn't match the other half. B is for border irregularity. The edges are ragged, notched, or blurred. C is for color. The pigmentation is not uniform. Shades of tan, brown, and black are present. Dashes of red, white, and blue add to the mottled appearance.

Changes in color distribution, especially the spread of color from the edge of a mole into the surrounding skin, also are an early sign of melanoma. D is for diameter. The mole or skin growth is larger than 6mm or about the size of a pencil eraser. Any growth of a mole should be of concern. E is for evolution. There is a change in the size, shape, symptoms, surface, or color of a mole.

Signs of melanoma in an existing mole include changes in the following aspects. (1) Elevation, such as thickening or raising of a previously flat mole. (2) Surface, such as scaling, erosion, oozing, bleeding, or crusting. (3) Surrounding skin, such as redness, swelling, or small new patches of color around a larger lesion. (4) Sensation, such as itching, tingling, or burning. (5) Consistency, such as softening or small pieces that break off easily.

Many other skin conditions have features similar to those of melanoma. Melanoma can develop in an existing mole or other mark on the skin, but it often develops in unmarked skin. Although melanoma can grow anywhere on the body, it often occurs on the upper back of men and women and on the legs in women.

Less often, it can grow on the soles, palms, nail beds, or mucous membranes that line body cavities such as the mouth, the rectum, and the vagina. On older people, the face is the most common place for melanoma to grow. And in older men, the most common sites are the neck, scalp, and ears. They are so common that they have a wide range of classifications.

Later signs of melanoma include a break in the skin or bleeding from a mole or other colored skin lesion, and pain in a mole or lesion. Symptoms of metastatic melanoma may be vague and include: swollen lymph nodes, especially in the armpit or groin; a colorless lump or thickening under the skin; unexplained weight loss; gray skin; ongoing cough; headaches; seizures.

Call your doctor immediately if you have been diagnosed with melanoma; you have difficulty breathing or swallowing; you cough up or spit up blood (hemoptysis); you have blood in your vomit or bowel movement ; your urine or bowel movement is black, and the blackness is not caused by taking iron or Pepto-Bismol.

Laser and electrocautery treatments are not always effective because they only reach the outermost layers of the skin, while moles penetrate very deep into the dermal tissue, often beyond the reach of these treatments. Surgery, the other option doctors commonly offer, involves cutting out the mole

Surgery for Melanomas

Nevi are so common that they have a wide range of classifications. Blue nevi occur very deep in the dermis. Compound nevi are very dark in color and are slightly raised. Intradermal nevi are usually flesh-colored and raised. Intramucosal nevi occur in the mouth or genital area. Nevi of ito and nevi of ota are found on the shoulder or face, which are flat and brownish in appearance.

Clark’s nevi are also called dysplastic nevi. They tend to stem from abnormal cell growth and can be pre-cancerous. These moles tend to be larger with irregular borders and coloration. As a result, they look like melanomas, and are often removed to confirm the diagnosis. Dysplastic nevi do not morph into melanomas, but are markers of risk when there are many of them.

Epidermal nevi usually appear on the upper half of the body. The recognized cause of these nevi is genetics. Giant hairy nevi are often very large and hairy and are unsightly. In terms of health, they can pose a risk as melanoma may be present in approximately 10-15% of the cases. Spitz nevi usually occur on children. They are often reddish in color and are raised.

Diagnostic punch or excisional biopsies may appear to excise the tumor, but further surgery is often necessary to reduce the risk of recurrence. Complete surgical excision with adequate margins and assessment for the presence of detectable metastatic disease along with short- and long-term followup is standard.

Often this is done by a wide local excision with 1 to 2 cm margins. Melanoma-in-situ and lentigo malignas are treated with narrower surgical margins, usually 0.2 to 0.5 cm. Many surgeons consider 0.5 cm the standard of care for standard excision of melanoma-in-situ, but 0.2 cm margin might be acceptable for margin controlled surgery (Mohs surgery).

The wide excision aims to reduce the rate of tumour recurrence at the site of the original lesion. This is a common pattern of treatment failure in melanoma. Considerable research has aimed to elucidate appropriate margins for excision with a general trend toward less aggressive treatment during the last decades.

Mohs surgery has been reported with cure rate as low as 77% and as high as 98% for melanoma-in-situ. Melanomas which spread usually do so to the lymph nodes in the region of the tumor before spreading elsewhere. Attempts to improve survival by removing lymph nodes surgically were associated with many complications but unfortunately no overall survival benefit.

Although controversial and without prolonging survival, sentinel lymph node biopsy is often performed, especially for T1b/T2+ tumors, mucosal tumors, ocular melanoma and tumors of the limbs. A process called lymphoscintigraphy is performed in which a radioactive tracer is injected at the tumor site in order to localize the sentinel nodes.

Further precision is provided using a blue tracer dye and surgery is performed to biopsy the nodes. Recently the technique of sentinel lymph node biopsy has been developed to reduce the complications of lymph node surgery while allowing assessment of the involvement of nodes with tumor.

As with other skin abnormalities, moles are classically removed by laser, surgery, or electrocautery. Most of these treatments require multiple visits to the doctor. Surgery, the option doctors commonly offer, involves cutting out the mole. The resulting wound requires stitches, which will in turn leave a scar.