MOLES, MELANOMA and SKIN
CANCER
Mary C. Martini, MD, FAAD
Associate Professor Dermatology
Director, Melanoma and Pigmented
Lesion Clinic
Northwestern University
MOLES
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Everyone gets moles
They can get bigger
and darker due to
sun burns and heavy
sun exposure
Some families make
“atypical” or
irregular moles
MOLES
MOLES
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Benign or healthy
moles
Irregular moles”dysplastic”
Melanoma
Dysplastic Nevus
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Multicolored
Asymmetric pigment
deposition
Asymmetric contourmacular and papular
Indistinct margins
Atypical mole syndrome(Dysplastic nevus syndrome)
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>100 melanocytic
nevi
1 or more nevi
>8mm in diameter
1 or more dysplastic
nevi on exam
Atypical Mole Syndrome has a
10 year risk of developing
melanoma of 14%
Wang et al.JAAD 2005;50:15-20
Management of the Dysplastic
Nevi Patient
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Close monitoring- full body exams every
6 months
Dermoscopy of all atypical appearing
nevi
Whole Body Photos
Excision of any changing or markedly
atypical nevi
Body Mapping Studio
positioning stage
 indexed monostand
 balanced crosslighting
 high resolution
digital camera
 body mapping
software

The Body Map
At Home Exam
Dermoscopy
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The magnified visualization of pigmented skin lesions
beyond what would be visible by the physician
Increases diagnostic accuracy by 10-20%
Dermlite.com
Benign Nevi
reticulated pattern
Dysplastic Nevi
Dysplastic Nevi
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Asymmetric pigment
pattern
Irregular
depigmentation
Irregular edge
Melanoma
Melanoma
Changes in Overall Cancer
Mortality (1975-2000)

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Prostrate -5%
Breast -15%
Colorectal -25%
MELANOMA +28%
Melanoma
Melanoma
Tumor Thickness- Breslow level
Level
<0.75mm
5yr survival
97.9%
0.76-1.49mm
1.5-3.99mm
>4mm
91.7%
72.8%
57.5%
Barnhill et al,Cancer 1996
Incidence of melanoma

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1900 - 1 in 2000
2004 - 1 in 70
Major cause is ultraviolet exposure
Tanning bed use before the age
of 35 increases the risk of skin
cancer by 75%
SUN DAMAGE
PHOTOAGING

Sun damage

Pollution

Heredity
LENTIGOS
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“Sunspots or big
freckles”
Increase in size and
color with more sun
exposure
Areas with these
growths may be
areas that develop
skin cancer years
later
Lentigo
Lentigo
Photodamage
Actinic Keratosis
SKIN CANCER
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Basal cell carcinoma
Squamous cell skin
cancer
Melanoma
Basal Cell Carcinoma
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Most common skin cancer
Never metastasizes
Sun damage is the major cause
Basal Cell Carcinoma
Basal Cell Carcinoma
Squamous Cell Carcinoma
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Second most common form of skin
cancer
Can metastasize if neglected and
continues to grow
Sun damage plays a major role
Squamous Cell Carcinoma
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Can occur in preexisting burn and
traumatic scars
Can occur on lower lip due to smoking
or chewing tobacco in addition to
actinic damage
Squamous Cell Carcinoma
Benign Lesions
Warts
Caused by a virus
 Spread by shedding
skin
 Treated by “cryo”,
5FU
or salicylic acid
plaster
-oral/genital warts linked
to cervical and
oral/throat cancer

WARTS
Angiomas
Seborrheic Keratosis
Dermatofibromas
Sebaceous Hyperplasia
SUNSCREENS
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Facial everyday sunscreens SPF 15-25: Eucerin facial,
Oil of Olay facial, Purpose
Chemical free- titanium dioxide and zinc oxide- Blue
Lizard and Neutragena
Waterproof sunscreens SPF 35-70: Coppertone sport,
Neutragena with helioplex, Blue lizard, in Canada or
Europe sunscreens with Mexoryl
Reapply every 2 hours if swimming or sweating
Skin Cancer Prevention
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Skin protection involves use of
sunscreens including reapplication
Wear sun screen containing clothing
and hats
Avoid prolonged sun exposure from 11
am to 3 pm