The early symptoms of melanoma at different stages are different

Melanoma occurs more often in middle-aged and elderly people, and is more common in men than in women. It is more common in the lower limbs and feet, followed by the trunk, head and neck, and upper limbs. The main symptoms are rapidly growing melanin nodules. Initially, melanin deposition may occur on normal skin, or pigmentation of moles may increase, and the black color may deepen. Then the lesions continue to expand, the hardness increases, and there is an itchy and painful feeling. Some melanoma lesions are raised, plaque-like, and nodular, while others are mushroom-like or cauliflower-like. When growing into the subcutaneous tissue, it appears as a subcutaneous nodule or mass, and when it spreads to the surrounding areas, star-shaped black spots or small nodules appear. A common manifestation is regional lymph node metastasis of melanoma, and even regional lymph node enlargement may lead to medical treatment. In the late stage, it is transferred to the lungs, liver, bones, and brain organs through the blood flow.

Clinical classification of melanoma

1. Superficial spreading type is the most common, accounting for about 70%. It is more common in people around 50 years old, and is more common in the limbs of women and in the trunk of men. Its malignancy is between the freckle type and the nodular type. In the early stage, it appears brown, brown, blue or black, and most of them can be rose red or pink, with jagged edges and disappearing skin texture. The radiation growth period lasts for 1 to 12 years, and less than 5% of patients develop lymph node metastasis during this period.

2. Freckle type accounts for 10% to 15% and is the least malignant of the four types. It is prone to occur in exposed areas such as the head, neck, and back of the hand. It is more common in people aged 60 to 70, and more common in women. Clinically, it manifests as a large, flat or slightly higher than the skin surface brown or brown lesion. When radial growth is accompanied by vertical growth, the local area is focally raised and the color is still brown. The lymph node metastasis rate is about 25%.

3. The nodular type is the most malignant of the four types, accounting for about 12%. It is more common in people around 50 years old, with a male-female ratio of 2:1. It is more common on the back. Clinically, it is a gray nodule with a pink color. When the lesion continues to grow, its color turns blue-black, and it appears as a purple-black jam-like dome or polyp-like mass. Vertical growth is its only growth mode. The course of the disease progresses rapidly, generally lasting for several months to 1 year, and ulcers and lymph node metastasis occur earlier. This type has a poor prognosis.

4. Acromelanotic melanoma mainly occurs on the palms, soles and subungual areas. During the radiation growth phase, the lesions are brown, brown or black and do not protrude above the skin surface. If irregular brown or brown stripes can be seen under the nail, they extend from the nail bed to the proximal end. The radiation growth phase lasts for about 1 year. If not treated in time, it will enter the vertical growth phase. The lesions appear nodular and the lymph node metastasis rate increases accordingly, and the prognosis is also poor.

Clinical staging estimates the disease stage based on the extent of the primary lesion, the presence of lymph node metastasis, and the presence of distant metastasis as determined by imaging examinations.

1. Stage I: No regional lymph node metastasis.

2. Stage II: accompanied by regional lymph node metastasis.

3. Stage III: accompanied by distant metastasis.

If pigmented skin lesions have the following changes, it often indicates the possibility of early melanoma

1. Color: Mottled color is a sign of malignant lesions. Freckle type and superficial spreading type often have red, white or blue mixed in brown or black, and blue is the worst.

2. Edge: It is often jagged and serrated, which is caused by the spread of the tumor or spontaneous degeneration.

3. Surface: Not smooth, often rough with scaly flaky desquamation, sometimes with bleeding and exudation, and may be higher than the skin surface.

4. Skin around the lesion: Edema may occur or the skin may lose its original luster or turn white or gray.

5. Abnormal sensation: local itching, burning pain or tenderness.

diagnosis

The diagnosis of melanoma is generally not difficult, and a few atypical cases need to be confirmed by pathological examination. Indirect immunofluorescence labeling of melanin tissue, double pAp immunoenzyme labeling assay and pigmentogen examination are helpful for diagnosis, and are helpful for the diagnosis of "non-pigmented" or oligo-pigmented melanoma and for distinguishing benign nevus cell tumors and whether they have become malignant.