Congenital black spots composed of melanocytes. It can be divided into a. intradermal nevus: it is located in the dermis, often protruding slightly from the skin or showing a papillary process, sometimes with hair (hairy nevus), which is the most common; B borderline nevus: located at the junction of epidermis and dermis, it grows actively, is flat, and has a deep pigment, which is easy to occur in hands and feet and can be malignant due to trauma, wear and infection; C. Mixed hydatidiform mole: It is located in the basal layer of epidermis and superficial layer of dermis, and its borderline nevus tends to be malignant.
Melanoma-melanoma
In daily life, some people have several moles, but few people pay more attention to these moles, because these moles have existed for a long time and may not have changed. However, once these moles are found to have changed, we should be highly vigilant, and they may evolve into an extremely terrible malignant tumor, which is called malignant melanoma in medicine.
The incidence of malignant melanoma has been relatively high in Europe and America, but relatively low in China. According to statistics, there are only 0.8 people/65,438+10,000 people. However, in recent years, due to air pollution, ozone layer destruction and ionizing radiation, the incidence of malignant melanoma has been on the rise. However, because patients often don't know enough about its severity, they often reach the late stage when they see a doctor, which leads to poor treatment effect. Therefore, we should pay enough attention to it.
1. What is malignant melanoma?
Malignant melanoma is caused by abnormal proliferation and malignant transformation of melanocytes, and its etiology is still unclear. In western countries, the incidence of white people is much higher than that of black people. In addition, the white skin of feet and palms is the main part, which may be related to excessive ultraviolet radiation and skin color.
This disease can occur at any age. In recent years, the incidence of young people seems to be rising. More than 90% of the primary diseases are in the skin, mostly occurring in the soles of feet, calves, fingers (toes), palms, nails, nail grooves, scalp, neck, vulva, and trunk skin. In addition, it can also occur in rectum, anus, esophagus and eyes, and even small intestine and other internal organs.
The main clinical manifestation is the rapid increase of melanin nodules. At first, normal skin can appear melanosis, or pigmented nevus increases and darkens, then the skin lesions expand and the hardness increases, accompanied by itching and pain. Some lesions of melanoma are bulges, patches and nodules, and some are mushroom-shaped and cauliflower-shaped. When it grows to subcutaneous tissue, it is subcutaneous nodule or mass type, and when it spreads around, it appears star-shaped black spots or small nodules, which are called "satellite" lesions. The development of the disease can gradually spread to the surrounding lymph nodes and many important organs of the whole body.
Second, be alert to the malignant transformation of moles.
Because almost 60% of malignant melanoma comes from malignant transformation of nevus, how to identify malignant transformation of nevus is particularly important for early diagnosis of melanoma.
Most moles are benign, with neat and uniform edges, black or dark brown, and it is easy to divide them into two symmetrical parts with a straight line. The malignant transformation of black hemorrhoids is characterized by irregularity, irregular circuitous and distorted edges; It is not uniform black, but variegated and interlaced, and it is usually impossible to divide it into two symmetrical parts with a straight line; At first, it was small and imperceptible, but gradually it grew to the size of the rubber head on the pencil, and it was clear at a glance.
If you find the following phenomena, you should be highly alert to the malignant transformation of moles: ① recent moles in adults. ② Within one year, the original moles increased obviously, the color deepened obviously, and they were shiny. ③ Discoloration of the original nevus: from brown to black, or from brown to dark brown spots. ④ The edge of nevus becomes irregular, or small satellite nevus appears, or several nevus fuse, and the surface is uneven. ⑤ Needle-like pain, itching and burning sensation appear locally. ⑥ Long-haired nevus suddenly appears hair loss for no reason. ⑦ The pigment of nevus disappears, the surface scabs, and inflammation, ulceration, running water or bleeding appear. Lymph nodes near nevus are enlarged. When some of the above symptoms appear, you should go to the specialized hospital for examination and treatment in time to find malignant lesions early.
Thirdly, standardized treatment of malignant melanoma is very important.
Of course, don't be alarmed if you find yourself suffering from malignant melanoma. Although the incidence of malignant melanoma is high at present, early treatment can obviously improve the curative effect. Because the disease is relatively rare in China, it is easy to be ignored. Therefore, we must go to an experienced specialist hospital and conduct comprehensive treatment through combined surgery, biological chemotherapy and biological therapy, so that patients with malignant melanoma can get effective treatment.
The treatment of malignant melanoma should adopt comprehensive treatment mode, and the initial patients should decide their treatment methods according to the specific stages of the tumor. For the treatment of early malignant melanoma, surgery is still the most effective treatment method, and the resection range should be determined according to the specific tumor site, especially the melanoma that occurs in limbs such as hands and feet. The principle is to keep the patient's limb function as much as possible while surgical resection, rather than amputation. Foreign studies have confirmed that expanding the scope of surgery can not prevent tumor recurrence. Some patients who came to the cancer hospital were referred, because other hospitals considered amputation and the patients did not agree. Through effective and standardized treatment, the limbs were preserved and the recurrence and metastasis were avoided.
However, many patients are inoperable when they see a doctor, and further treatment is needed for advanced patients with distant metastasis or high-risk patients who are prone to recurrence after surgery. This disease is sensitive to biotherapy. Combined with chemotherapy, we call it biotherapy, and the effective rate can be increased from 10% to about 20% ~ 30%.
Specific tumor immunotherapy has great potential in the treatment of malignant melanoma and may become the most important treatment for the disease. Beijing Cancer Hospital used dendritic cell immunotherapy combined with hyperthermia to treat metastatic malignant melanoma, which has won the national invention patent. Clinical application for more than two years has proved that this method has good curative effect on metastatic melanoma.
After surgery and biological treatment, the five-year survival rate of patients with early malignant melanoma can reach 60% ~ 80%, while the five-year survival rate of patients with advanced malignant melanoma is less than 5%. At the same time, malignant melanoma is prone to recurrence and metastasis, so the prognosis of this disease is poor, and more attention should be paid to early detection, early diagnosis and early treatment.
Fourth, prevent malignant melanoma.
Because the incidence of malignant melanoma is related to ultraviolet radiation, it is necessary to minimize unnecessary sunlight exposure. Through self-examination in daily life, the malignant transformation of moles can be found early.
When you find the high-risk signs of malignant transformation of the above-mentioned moles, or have concerns about your own moles, don't be careless, let alone scratch or scrape. Because any stimulus can promote the spread of tumor, you must go to an experienced specialist medical hospital in time.
In addition, for some moles located in special parts, such as soles of feet, palms, vulva and other parts that are easy to rub the skin, we should go to the hospital for surgical resection to avoid the malignant transformation of moles after frequent rubbing.