These presentation is a short presentation of malignant melanoma and presented by Mo. Haroon Rashid in Florence College of Nursing Limtara Dhamtari

1. Malignant Melanoma
By
Mo. Haroon Rashid

2. Introduction
• Melanoma is a very serious from of skin
cancer.
• Melanoma is cancer of the melanocytes.
• Melanocytes are located in the stratum
basale and produce melanin.
• When skin is exposed to sunlight
melanocytes produce more pigment, causing
the skin to tan.
• Sometimes, clustera of melanocytes form
noncancerous growths called moles.
•

3. Introduction
• malignant melanoma can spread through both the
bloodstream and lymphatic system and can
metastasize to the bones, liver, lungs, CNS and lymph
nodes.
• A malignant melanoma is a malignant neoplasm in
which atypical melanocytes are present in both the
epidermis and the dermis.
• It is the most lethal of all skin cancers. It can occur in
one of several forms.
• Melanoma is a type of skin cancer that originates
from the cells in the skin responsible
for pigmentation (colour), known as melanocytes.

4. Definition
According to “Ross and Wilson”
Melanoma is a type of skin cancer that originates from
the cell in the skin responsible for pigmentation,Known
as melanocytes. Melanoma can occur in adults of
children in rare case present in at birth.
According to “Dr.Imtiyaz Wani”
Melanoma is a most dangerous or serious type of skin
cancer, develops in the cells (Melanocytes) that
poroduce melanin the pigment that gives your skin its
colour. Mealnoma can also form in your eyes and
rarely in internal organs such as your intestines.

5. INCIDENCE
Although melanoma accounts for only about 5% of all
skin cancer cases, it causes most skin cancer related
deaths.
The incidence is rising by 3%.
• About 96,480 new melanomas will be diagnosed
(about 57,220 in men and 39,260 in women).
• About 7,230 people are expected to die of
melanoma (about 4,740 men and 2,490 women).
• The rates of melanoma have been rising for the
last 30 years.

6. TYPES OF
MALIGNANT
MELANOMA

7. 1.Superfecial Spreading
Melanoma
• The cells tend to grow slowly at
first, before spreading across the
surface of the skin.
• Superficial spreading
melanoma is a type of skin
cancer that slowly grows
horizontally across the top layer
of skin before moving to the
deeper layers. It's the most
common form of melanoma,
accounting for 70 percent of all
cases

8. 2.Nodular Melanoma
• Nodular melanoma is a type
of skin cancer. It's a
dangerous form
of melanoma that grows
quickly. Only about 15% of
all melanomas are nodular.
But it causes nearly half
of melanoma-related deaths.
So you need to know the sign.
• It tends to grow more quickly
than other types, turning
red—rather than black—as it

9. 3.Lentigo Malignant Melanoma
• This is less common, and tends to
affect older people, especially in
parts of the body that have been
exposed to the sun over several
years.
• Lentigo maligna melanoma is
a melanoma that has evolved from
a lentigo maligna. They are
usually found on chronically sun
damaged skin such as the face and
the forearms of the elderly. The
nomenclature is very confusing to
both patients and physicians alike.

10. 4.Acral Lentiginous Malignant
• This is the rarest kind of
melanoma. It usually appears on
the palms of the hands, soles of the
feet, or under the nails.
• Acral lentiginous
melanoma (ALM) is a specific
type of melanoma that appears on
the palms of the hands, the soles of
the feet, or under the nails.
Melanocytes contain your skin
color (known as melanin or
pigment). In this type
of melanoma, the word “acral”
refers to the occurrence of
themelanoma on the palms or

11. Causes of Malignant Melanoma

12. 1.Sun Exposure
• Ultraviolet (UV) rays
are an invisible form
of radiation. They can
pass through your skin
and damage your skin
cells. Sunburns are a
sign of skin damage

13. 2.Personal History Of Skin
Cancer

14. 3.Excessive Ultraviolet light
exposure
• Exposure to UV
radiation, which
comes from the sun
and from tanning
lights and beds, can
increase the risk of
skin cancer, including
melanoma.

15. 4.Weakened Immune System
• People with
weakened immune
systems, such as
those who've
undergone organ
transplants, have an
increased risk of
skin cancer.

16. 5.Fair Skin
• Having less pigment
(melanin) in your skin means
you have less protection from
damaging UV radiation. If
you have blond or red hair,
light-colored eyes, and freckle
or sunburn easily, you're more
likely to develop melanoma
than is someone with a darker
complexion. But melanoma
can develop in people with
darker complexions, including
Hispanics and blacks.

17. Pathophysiology

18. Sign and Symptom

19. 1. Change skin in afeected Part

20. 2. Skin Sore

21. 3. Pain in Affected part

22. 4. Redness of Affected Area

23. 5. Development of Blister in Affectd
Part

25. Stages of Malignant
Melanoma

26. Stag - 0
• In Stage 0 melanoma,
the malignant tumor is still
confined to the upper layers
of the skin. This means that
the cancer cells are only in the
outer layer of the skin and
have not grown any deeper.
The term for this is in situ,
which means “in place” in
Latin. There is no evidence
the cancer has spread to
the lymph nodes or distant
sites (metastasis).

27. Stag - 1
• Stage I melanoma is
defined as a melanoma
that is up to 2mm
thick. A Stage I
melanoma may or may
not have ulceration. There
is no evidence the cancer
has spread to lymph
nodes or distant sites
(metastasis).

28. Stag - 2
• Stage II melanoma is
defined by
tumor thickness, and
ulceration. There is
no evidence the cancer
has spread to the
lymph nodes or distant
sites (metastasis).

29. Stag - 3
• Stage III melanoma is
defined by the level of
lymph node
involvement and
ulceration. In Stage III
melanoma, the depth of
the melanoma no longer
matters. There is no
evidence the cancer has
spread to distant sites
(metastasis)

30. Stag - 4
• Stage IV melanoma occurs
when the melanoma has
spread beyond the original
site and regional lymph
nodes to more distant areas of
the body. The level of LDH
(serum lactate dehydrogenase)
may or may not be elevated.
The most common sites of
metastasis are to vital organs
(lungs, abdominal organs,
brain, and bone) and soft
tissues (skin, subcutaneous
tissues) and distant lymph
nodes (lymph nodes beyond the
primary tumor region).

31. • Complete blood Count
• Chest Radiography
• MRI
• CT Scan
• Biopsy
• History Taking
• Physical Examination
Diagnostic Evaluation

32. • Complete blood Count
• Chest Radiography
• MRI
• CT Scan
• Biopsy
• History Taking
• Physical Examination
Diagnostic Evaluation

33. • A – Asymmetric
• B - Border
• C – Colour
• D – Diameter
• E – Evolving
Diagnostic Evaluation

34. Management of
Malignant melanoma

35. Medical Management
• Chemotherapy is an
aggressive form of chemical
drug therapy meant to destroy
rapidly growing cells in the
body. It’s usually used to treat
cancer, as cancer cells grow
and divide faster than other
cells. A doctor who
specializes in cancer treatment
is known as an oncologist.
They’ll work with you to
come up with your treatment
plan.

36. 2.Radiation Therapy
• Radiation therapy (also
called radiotherapy) is a
cancer treatment that uses
high doses of radiation to
kill cancer cells and shrink
tumors. At low doses,
radiation is used in x-rays
to see inside your body, as
with x-rays of your teeth
or broken bones.

37. 3. Biological Therapy
• Biological therapy boost
immune system to help
body fight cancer. These
therapy is improve the
body immune system and
fight the against of cancer.
These therapy is used to
treatment of Malignant
melanoma.

38. • Wide Excision :- Excision simply means “to
cut out.” Surgical excision can be used to
treat melanoma and non-melanoma skin
cancer. Excision is also called “wide
excision.” This is because the tumor is cut
out together with some of the healthy skin
around it. The healthy skin is called a margin.
The reason for taking a margin is to remove
any cancer cells that have spread into the
surrounding tissue.
Surgical Management

39. • Mohs Surgery Mohs surgery is a precise surgical
technique used to treat skin cancer. During
Mohs surgery, thin layers of cancer-containing
skin are progressively removed and examined
until only cancer-free tissue remains. Mohs
surgery is also known as Mohs micrographic
surgery.
• The goal of Mohs surgery is to remove as much
of the skin cancer as possible, while doing
minimal damage to surrounding healthy tissue.
Mohs surgery is usually done on an outpatient
basis using a local anesthetic.
Surgical Management

40. • Avoiding excessive exposure to ultraviolet
radiation can reduce the risk of skin cancer.
• Avoiding sunburn
• Wearing clothes that protect against the sun
• Using sun screen with a sun protection.
• Protecting children by keeping them in the
shade with clothing and by applying sun
screen.
• To maintain body ability.
Nursing Management

41. • Scarring
• Pain
• Infection of skin
• Skin Necrosis
• Lymphoedema
• Chronic pain
• wound
Complication

42. Thank
you All
of You