Melanomais a malignant tumor of melanocytes which are found predominantly inskin but also in the bowel and the eye. It is one of the less commontypes of skin cancer but causes the majority of skin cancer relateddeaths. Melanocytes are normally present in skin, being responsiblefor the production of the dark pigment melanin.
Around60,000 new cases of invasive melanoma are diagnosed in the US eachyear, more frequently in males and in Caucasians. It is more commonin Caucasian populations living in sunny climates than in othergroups, or in those who use tanning salons. According to a WHO reportabout 48,000 melanoma related deaths occur worldwide per year.
Excisionalskin biopsy is the management of choice for melanoma diagnosis; thisis where the suspect lesion is totally removed with an adequateellipse of surrounding skin and tissue. The preferred surgical marginfor the initial biopsy should be narrow in order to prevent thedisruption of the local lymphatic drainage.
Thebiopsy will include the epidermal, dermal, and subcutaneous layers ofthe skin, enabling the histopathologist to determine the thickness ofthe melanoma by microscopic examination. This is described byBreslow’s thickness. Large initial excision will disrupt the locallymphatic drainage and can affect further lymphangiogram directedlymphnode dissection.
Asmall punch biopsy can be utilized at any time where for logisticaland personal reasons a patient refuses more invasive excisionalbiopsy. Small punch biopsies are minimally invasive and heal quickly,usually without noticeable scarring. Thus, a small punch biopsy inrepresentative areas will give adequate information and will notdisrupt the final staging or depth determination.
Forlarge lesions such as suspected lentigo maligna, or for lesions insurgically difficult areas (face, toes, fingers, eyelids), a smallpunch biopsy in representative areas would be enough. In nocircumstances should the initial biopsy include the final surgicalmargin, as a misdiagnosis can result in excessive scarring andmorbidity from the procedure.
Lactatedehydrogenase (LDH) tests are often used to screen for metastases,although many patients with metastases have a normal LDH;extraordinarily high LDH often indicates metastatic spread of thedisease to the liver. It is common for patients diagnosed withmelanoma to have chest X-rays and an LDH test, and in some cases CT,MRI, PET or PET/CT scans.
Althoughcontroversial, sentinel lymph node biopsies and examination of thelymph nodes are also performed in patients to assess spread to thelymph nodes. Sometimes the skin lesion may bleed, itch, or ulcerate,although this is a very late sign. A slow-healing lesion should bewatched closely, as that may be a sign of melanoma. Some patientswith metastatic melanoma do not have an obvious detectable primarytumor.
Beaware also that in circumstances that are still poorly understood,melanomas may “regress” or spontaneously become smaller orinvisible; however the malignancy is still present. Amelanoticmelanomas do not have pigment and may not even be visible. Lentigomaligna, a superficial melanoma confined to the topmost layers of theskin is often described as a “stain” on the skin.
Thetreatment includes surgical removal of the tumor, adjuvant treatment,chemotherapy, immunotherapy, or radiation therapy. NeviCurativeprovides a safe and effective alternative to current medicaltreatments that can be invasive and expensive. It provides totalclearance of moles without any recurrence, discomfort, or tissuedamage.
Thetherapeutic action of NeviCurative is accomplished via its rapidabsorption into the skin where moles occur. The certified organicantimicrobial plant extracts in NeviCurative are lipophilic (easilyabsorbed into fatty tissue such as the skin) and have a low molecularweight. This allows them to pass readily through skin tissue and intocell membranes where they eradicate nevi.
Nothingpenetrates into cell membranes and removes nevi with the swiftnessand efficacy of NeviCurative. NeviCurative produces deep penetratingresults and eliminates nevi quickly because it contains the mostpotent certified organic antimicrobial medicinal plant extracts onthe planet. To learn more, please go to http://www.bcured.net.

About the author staff of Nature Power Company, which is a network company dedicated to promoting customers’ websites and developing softwares. You can go to the following websites to learn more about our natural organic products. http://www.bcured.net http://www.naturespharma.org

Source: http://www.articlesalley.com/article.detail.php/127681/63////Excisional_Skin_Biopsy_for_Melanoma


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