Melanoma Review: Background and Treatment

Eva Berrios-Colon, PharmD, MPH, BCPS; Shalonda Williams, PharmD

Disclosures

US Pharmacist 

In This Article

Pathophysiology

The developmental pathway of melanoma involves a series of distinct steps; however, not all steps must occur in order for melanoma to develop. Morphologic stages include melanocytic atypia, atypical melanocytic hyperplasia, radial growth phase, primary melanoma in the vertical growth phase with or without in-transit metastases, regional lymph node metastatic melanoma, and distant metastatic melanoma.[3]

The main goal is to diagnose melanoma early to prevent tumor invasion and metastasis. The classic clinical presentation of melanoma varies by type. Early detection may be facilitated by using the ABCDE mnemonic to assess a mole: Asymmetry; Border irregularity; Color variation or recent color change; Diameter (increasing or >6 mm); Evolving lesion, including surface changes (i.e., any change in shape, size, color, or elevation) and the development of new symptoms (e.g., bleeding, itching). Several characteristics are used to help distinguish benign nevi from atypical nevi, including size, shape, color, location, and number. If any abnormality is suspected, a dermatologist should perform a comprehensive skin examination, and a biopsy may be warranted.[3] This step is critical for evaluating a patient with multiple or atypical nevi, a history of excessive sun exposure, or melanoma.[4]

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