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Chapter 18. Cutaneous Melanoma

AE is a 28-year-old woman in clinic today for routine annual check-up with her general practitioner. AE’s older brother was recently treated for basal cell carcinoma. Which of the following are risk factor(s) associated with melanoma AE should be educated about? Select all that apply.

a. Presence of multiple dysplastic nevi

b. Presence of genetic factors

c. Individuals with fair skin type who sunburns easily

d. Individuals who are immunosuppressed

Answer a is correct. Presence of multiple dysplastic nevi is a risk factor associated with melanoma.

Answer b is correct. Presence of inherited genetic factors (ie, xeroderma pigmentosum, familial atypical multiple mole syndrome, and hereditary dysplastic nevus syndrome) are risk factors associated with melanoma.

Answer c is correct. Individuals with fair skin type who sunburns easily are more likely to develop melanoma.

Answer d is correct. Individuals who are immunosuppressed are more likely to develop melanoma.

Which of the following statements is true regarding the subtypes of melanoma? Select all that apply.

a. Superficial spreading melanomas are the most common type of melanomas with lesions usually arising from preexisting nevus.

b. Nodular melanomas are fast-growing lesions that develop and spread in a vertical growth phase pattern.

c. Lentigo maligna melanomas are more commonly reported in children, with lesions less likely to metastasize.

d. Uveal melanomas are rare lower extremity malignancies arising from pigmented epithelium of the choroids, with lesions more likely to metastasize to liver.

Answer a is correct. Superficial spreading melanoma is the most common type of melanoma, making up about 70% of all cases of melanoma, and is more common in women than men. The lesions usually arise from a preexisting nevus, with initial presentation appears as flat which later develops as irregular and asymmetrical.

Answer b is correct. Nodular melanoma is the second most common type of melanoma, making up about 15% to 30% of all cases of melanoma, and is more common in men than women. Unlike superficial spreading melanoma, nodular melanoma has a more aggressive and rapid growth pattern, with lesions develop and spread in a vertical growth phase pattern. The lesions are usually dark blue-black and uniform in color, and are most commonly located on the head, neck and trunk.

Answer c is incorrect. Lentigo maligna melanoma comprise a smaller percentage of all cases of melanoma and is commonly occurs in older age group, typically located on the face ...

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