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| | __NOTOC__ |
| '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
| {{Infobox_Disease |
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| Name = Melanoma |
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| Image = Melanoma malignum.jpg|
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| Caption = Melanoma malignum on the left leg of a 60-year-old woman |
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| Width = 225 |
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| DiseasesDB = 7947 |
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| ICD10 = {{ICD10|C|43||c|43}} |
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| ICD9 = {{ICD9|172}} |
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| ICDO = {{ICDO|8720|3}} |
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| OMIM = 155600 |
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| MedlinePlus = 000850 |
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| eMedicineSubj = derm |
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| eMedicineTopic = 257 |
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| }}
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| {{CMG}}
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| {{Editor Join}}
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| {{Melanoma}} | | {{Melanoma}} |
| ==[[Melanoma overview|Overview]]==
| | {{CMG}} {{AE}} {{YD}}; {{SSK}}{{Sab}} |
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| ==[[Melanoma historical perspective|History]]==
| | {{SK}} Malignant melanoma; Acral lentiginous melanoma; Lentiginous melanoma; Lentigo maligna melanoma; Nodular melanoma; Amelanotic melanoma; Familial melanoma; Non-pigmented melanoma; MM; Metastatic melanoma; Metastatic malignant melanoma; Cutaneous melanoma; Actinic melanosis; Solar melanoma; Melanose; Malignant nevus; Melanocyte malignancy; Melanotic cancer |
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| ==Epidemiology==
| | ==[[Melanoma overview|Overview]]== |
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| The incidence of melanoma has increased in the recent years, but it is not clear to what extent changes in behavior, in the environment, or in early detection are involved.<ref>{{cite journal | author = Berwick M, Wiggins C | title = The current epidemiology of cutaneous malignant melanoma. | journal = Front Biosci | volume = 11 | issue = | pages = 1244-54 | year = | id = PMID 16368510}}</ref>
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| ==[[Melanoma causes|Causes]]== | |
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| ==[[Melanoma risk factors|Risk factors]]== | | ==[[Melanoma historical perspective|Historical Perspective]]== |
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| | ==[[Melanoma classification|Classification]]== |
| ==[[Melanoma pathophysiology|Pathophysiology]]== | | ==[[Melanoma pathophysiology|Pathophysiology]]== |
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| == Diagnosis == | | ==[[Melanoma causes|Causes]]== |
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| :[[Melanoma history and symptoms| History and Symptoms]] | [[Melanoma physical examination | Physical Examination]] | [[Melanoma staging | Staging]] | [[Melanoma laboratory tests | Lab Tests]] | [[Melanoma electrocardiogram|Electrocardiogram]] | [[Melanoma x ray|X Ray]] | [[Melanoma MRI|MRI]] | [[Melanoma CT|CT]] | [[Melanoma echocardiography|Echocardiography]] | [[Melanoma other imaging findings|Other imaging findings]] | [[Melanoma other diagnostic studies|Other diagnostic studies]]
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| ==Treatment== | | ==[[Melanoma differential diagnosis|Differentiating Melanoma from other Diseases]]== |
| Treatment of advanced malignant melanoma is performed from a multidisciplinary approach including [[Dermatology|dermatologists]], medical [[oncologists]], radiation oncologists, surgical oncologists, general surgeons, [[plastic surgery|plastic surgeons]], [[neurologists]], [[neurosurgeons]], [[otorhinolaryngologists]], [[radiologists]], [[pathologists]]/dermatopathologists, research scientists, [[nurse practitioner]]s and [[physician assistant]]s, and [[palliative care]] experts. Nurse practitioners (NPs) and physician assistants (PAs) are qualified to evaluate and treat patients on behalf of their supervising physicians. Treatment guidelines can be found through many resources available to health care professionals around the world. Inspired by melanoma’s increasing prevalence, researchers are seeking to understand the pathways that regulate [[melanin]] production.
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| [[Melanoma medical therapy|Medical therapy]] | [[Melanoma surgery|Surgical options]] | [[Melanoma primary prevention|Primary prevention]] | [[Melanoma secondary prevention|Secondary prevention]] | [[Melanoma cost-effectiveness of therapy|Financial costs]] | [[Melanoma future or investigational therapies|Future therapies]] | | ==[[Melanoma epidemiology and demographics|Epidemiology and Demographics]]== |
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| ==Equine melanoma== | | ==[[Melanoma risk factors|Risk Factors]]== |
| Melanomas are also not uncommon in horses, being largely confined to grey (or white) animals - 80% of such pale horses will develop melanomata by 15 years of age<ref name=CeCO>Centre for Comparitive Oncology [http://www.vetmed.vt.edu/ceco/melanoma.html], accessed at 2220 on 12th July</ref>; of these, 66% are slow growing but all may be classified as malignant<ref name=CeCO/>. [[Surgical]] excision may be attempted in some cases, if the tumours are limited in extent and number. However, they are often multiple (especially in older animals) and [[perineal]] tumours are notoriously difficult to excise. Often, a position of "benign neglect" is assumed, especially if the tumours are not causing any [[clinical]] problems. [[Medical]] therapy with [[cimetidine]] (2.5-4.0mg/kg three times daily for 2 months or more)<ref>Warnick, LD, Graham, ME, and Valentine, BA (1995) "Evaluation of cimetidine treatment for melanomas in seven horses" ''Equine Practice'', 17(7): 16-22, 1995</ref> is also an option, although it has a lower success rate than [[surgery]] and [[cryosurgery]]<ref> RJ Rose & DR Hodson, ''Manual of Equine Practice'' (p. 498) 2000</ref>.
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| ==Future thought== | | ==[[Melanoma screening|Screening]]== |
| <p>One important pathway in [[melanin]] synthesis involves the transcription factor [[MITF]]. The MITF gene is highly conserved and is found in people, mice, birds, and even fish. MITF production is regulated via a fairly straightforward pathway. [[UV radiation]] causes increased expression of transcription factor [[p53]] in [[keratinocytes]], and p53 causes these cells to produce melanoctye stimulating hormone ([[MSH]]), which binds to [[MC1R]] receptors on [[melanocytes]]. Ligand-binding at MC1R receptors activates [[adenyl cyclases]], which produce [[cAMP]], which activates [[CREB]], which promotes [[MITF]] expression. The targets of MITF include [[p16]] (a CDK inhibitor) and [[Bcl2]], a gene essential to [[melanocyte]] survival. It is often difficult to design drugs that interfere with transcription factors, but perhaps new drugs will be discovered that can impede some reaction in the pathway upstream of MITF.
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| <p>Studies of [[chromatin]] structure also promise to shed light on transcriptional regulation in melanoma cells. It has long been assumed that [[nucleosomes]] are positioned randomly on [[DNA]], but murine studies of genes involved in melanin production now suggest that nucleosomes are stereotypically positioned on DNA. When a gene is undergoing transcription, its transcription start site is almost always nucleosome-free. When the gene is silent, however, nucleosomes often block the transcriptional start site, suggesting the nucleosome position may play a role in gene regulation.
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| <p>Finally, given the fact that tanning helps protect skin cells from UV-induced damage, new melanoma prevention strategies could involve attempts to induce tanning in individuals who would otherwise get sunburns. Redheads, for example, do not tan because they have MC1R mutations. In mice, it has been shown that the melanin-production pathway can be rescued downstream of MC1R. Perhaps such a strategy will eventually be used to protect humans from melanoma.
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| ==References== | | ==[[Melanoma natural history|Natural History, Complications and Prognosis]]== |
| {{Reflist|2}}
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| ==External links== | | == Diagnosis == |
| ===Websites===
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| *[http://www.mmmp.org Melanoma Molecular Map Project]
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| *[http://www.proleukin.com Proleukin]
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| *[http://www.melanomaperspectives.com Melanoma Perspectives]
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| *[http://www.skincancer.org/melanoma/index.php Information on Melanoma from The Skin Cancer Foundation]
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| * [http://www.cimit.org/ CIMIT Center for Integration of Medicine and Innovative Technology - New Advances and Research in Melanoma]
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| * [http://www.newsmonster.co.uk/sunlight-prevents-and-cures-cancer-and-a-healthy-tan-makes-you-look-good.html Sunbathing helps prevent cancer: UK newspaper article]
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| * [http://www.melanomainternational.org/ Melanoma International Foundation]
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| * [http://www.skincheck.org/ Melanoma Education Foundation]
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| * [http://www.melanoma.com/ melanoma.com] (commercially supported site)
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| * [http://www.dermnetnz.org/lesions/melanoma.html DermNet NZ: Melanoma]
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| * [http://www.startoncology.net/capitoli/interno_capitoli/default.jsp?menu=professional&ID=32&language=eng Professional melanoma information]
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| * [http://www.rah.sa.gov.au/cancer/melanoma/ Adelaide Melanoma Unit] (free information on diagnosis, prevention, treatment of melanoma; booklet available at cost)
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| *[http://copublications.greenfacts.org/en/sunbeds/index.htm Assessing health risks of sunbeds and UV exposure] summary by GreenFacts of the European Commission SCCP assessment
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| ===Patient information===
| | [[Melanoma staging | Staging]] | [[Melanoma history and symptoms| History and Symptoms]] | [[Melanoma physical examination | Physical Examination]] | [[Melanoma laboratory tests | Laboratory Findings]] | [[Melanoma biopsy|Biopsy]] | [[Melanoma chest x ray|Chest X ray]] | [[Melanoma CT|CT]] | [[Melanoma MRI|MRI]] | [[Melanoma echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Melanoma other imaging findings|Other Imaging Findings]] | [[Melanoma other diagnostic studies|Other Diagnostic Studies]] |
| * [http://www.cancer.gov/pdf/WYNTK/WYNTK_moles.pdf What You Need To Know About Moles and Dysplastic Nevi] - patient information booklet from cancer.gov (PDF)
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| * [http://www.mpip.org/ MPIP: Melanoma patients information page]
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| * [http://www.MelanomaSupport.org.au/ Melanoma Support Organisation (Victoria, Australia)] - Ran by Melanoma Sufferers with strong links to Cancer Institutes in Victoria, Australia
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| * [http://www.melanomapatients.org/ Melanoma Patients Australia]
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| * [http://www.tustison.com/interests1.shtml/ Mikes Page - The Melanoma Resource Center]
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| * [http://listserv.icors.org/SCRIPTS/WA-ICORS.EXE?SUBED1=mel-l&A=1/ MEL-L - Melanoma e-mail list for patients, caregivers and healthcare professionals] - Supporting the Melanoma Patient since 1996
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| ===Images, photographs=== | | ==Treatment== |
| *[http://www.dermnet.com/thumbnailIndex.cfm?moduleID=14&moduleGroupID=427&groupIndex=0&numcols=0 Melanoma photo library at Dermnet]
| | [[Melanoma medical therapy|Medical Therapy]] | [[Melanoma surgery|Surgery]] | [[Melanoma primary prevention|Primary Prevention]] | [[Melanoma secondary prevention|Secondary Prevention]] | [[Melanoma cost-effectiveness of therapy|Cost Effectiveness of Therapy]] | [[Melanoma future or investigational therapies|Future or Investigational Therapies]] |
| * [http://dermatlas.med.jhmi.edu/derm/result.cfm?Diagnosis=53 DermAtlas: Melanoma images]
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| * [http://www.lumen.luc.edu/lumen/MedEd/medicine/dermatology/melton/melcont.htm Photographs of melanoma]
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| * [http://melanoma.blogsome.com/ Skin imaging methods for melanoma diagnosis](commercial advertising)
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| * [http://dermatologie.free.fr/cas21b.htm Pictures of melanomas]
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| * [http://dermatologie.free.fr/cas183re.htm Pictures of amelanotic melanomas]
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| ===Videos=== | | ==Case Studies== |
| * [http://www.healthination.com/skin_cancer.php Health Video: Melanoma and Non-Melanoma Skin Cancers - Overview, Prevention, and Treatment]
| | :[[Melanoma case study one|Case #1]] |
| * [http://www.healthination.com/skin_self_exam.php Health Video: How to Perform a Skin Self Exam]
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| | {{Epithelial neoplasms}} |
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| {{Epithelial neoplasms}}
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| [[Category:Dermatology|Melanoma]] | | [[Category:Dermatology|Melanoma]] |
| [[Category:Types of cancer|Melanoma]] | | [[Category:Types of cancer|Melanoma]] |
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| | [[Category:Disease]] |
| | [[Category:Oncology]] |
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| {{WikiDoc Help Menu}} | | {{WikiDoc Help Menu}} |
| {{WikiDoc Sources}} | | {{WikiDoc Sources}} |
| | | [[Category:Up-To-Date]] |
| [[be-x-old:Мэлянома]] | | [[Category:Oncology]] |
| [[bg:Меланома]]
| | [[Category:Medicine]] |
| [[ca:Melanoma]]
| | [[Category:Dermatology]] |
| [[da:Malignt melanom]]
| | [[Category:Surgery]] |
| [[de:Malignes Melanom]]
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| [[et:Melanoom]]
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| [[es:Melanoma]]
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| [[fr:Mélanome]]
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| [[gl:Melanoma maligno]]
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| [[it:Melanoma]]
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| [[he:מלנומה]]
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| [[la:Melanoma Malignus]]
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| [[nl:Melanoom]]
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| [[ja:悪性黒色腫]]
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| [[no:Malignt melanom]]
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| [[pl:Czerniak złośliwy]]
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| [[pt:Melanoma maligno]]
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| [[ru:Меланома]]
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| [[sr:Меланом]] | |
| [[fi:Melanooma]] | |
| [[sv:Malignt melanom]] | |
| [[zh:黑色素瘤]] | |