It can arise on apparently healthy skin or from the modification of a pre-existing mole. It is melanoma, a skin cancer that in Italy ranks third for incidence under 50 years of age. Different forms of melanoma: superficial diffusion, nodular, acral lentiginous and lentigo maligna type. Ignazio Stanganelli, Head of Skin Cancer Unit of the Romagna Institute for the study of Tumors ‘Dino Amadori’ and associate professor of the University of Parma, in an interview published on the Aleati per la Salute website (www.alleatiperlasalute.it) the new portal dedicated to medical-scientific information created by Novartis, underlines the role of primary prevention “essential – he says – already in the pediatric age. From an early age, in fact, it is necessary to adopt adequate behaviors during sun exposure because otherwise it can contribute to the development of a melanoma “.
But how to recognize an “anomalous mole”? Stanganelli indicates in irregular shape and inhomogeneous colors the morphological characteristics to be considered in order to identify the “different nevus”, a pigmented lesion that stands out from all the others, because “the recognition of the so-called” ugly duckling “is fundamental,” he says.
There are also analytical variables that serve to make a more precise assessment, i.e. specific characteristics that correspond to the first five letters of the ABCDE alphabet and that are used to evaluate a suspicious nevus: asymmetry, irregular edges, inhomogeneous or black color, dimensions greater than 6 mm , evolution (change in size and appearance, even rapid). “These criteria – explains Stanganelli – also represent important tools for carrying out a self-examination and possibly to request the opinion of your doctor, who could direct you to a specialist visit to a dermatologist”. Which analyzes the skin with the naked eye and, through the support of the dermatoscope, an instrument equipped with a light and a lens that allows you to enlarge the lesion by 10 times, considerably increasing the number of correct diagnoses.
“Thanks to the dermoscopy technique – underlines Stanganelli – we are able to reduce the number of unnecessary removals, improving early diagnosis”, which is essential for prompt intervention in the case of melanoma. In case of difficulty in reaching a sure differential diagnosis between melanoma and atypical nevus, the procedure is to proceed in any case with the removal and a subsequent histological examination. In the presence of many atypical flat nevi, digital videodermatoscopy (so-called computerized mapping) can be used up to confocal microscopy. These methods are decided by the specialist and performed by expert dermatologists.
“The role of primary prevention is essential from an early age” says Stanganelli who, with the arrival of summer, recommends exposure to the sun in a moderate manner from childhood, avoiding sun burns, exposure to the sun during hottest hours of the day and the use of tanning beds. The use of a t-shirt, hat, sunglasses and above all the regular use of high Spf sunscreen is also recommended.
As far as early diagnosis is concerned, it can be facilitated by considering in particular the categories most at risk: people with fair complexion and who burn easily; with personal history of previous melanoma; who are familiar with this tumor. “The whole population, but in particular these people – concludes Stanganelli – must pay attention to the health of their skin and any alarm bells, regularly undergoing specialist visits and dermatological checks”. In general, a visit every 2 years is recommended, but in the case of subjects at risk the frequency must be increased and a check-up can be prescribed even every 2-3 months. The expert’s intervention is available on: https://www.alleatiperlasalute.it/il-melanoma-limurezza-di-una-diagnosi-precoce.