Malignant melanomahttps://en.wikipedia.org/wiki/Melanoma
Malignant melanoma bụ ụdị kansa anụ ahụ nke na-esi na mkpụrụ ndụ na-emepụta pigment a na-akpọ melanocytes. N’ime ụmụ nwanyị, ọ na-apụtakarị n’akpụkpọ ụkwụ, ebe n’ime ụmụ nwoke, ọ na-apụtakarị n’akpụkpọ azụ. Ihe dị ka 25 % nke melanoma na-etolite site na nevi. Mgbanwe na nevi ndị nwere ike igosi melanoma gụnyere mmụba nha, ọdịdị na-adịghị ahụkebe, mgbanwe agba, ma ọ bụ ọnya.

Isi ihe na-akpata melanoma bụ ìhè ultraviolet, karịsịa n’ime ndị nwere obere melanin (akpụkpọ anụ ọcha). Ìhè UV nwere ike ịbịa site n’anwụ ma ọ bụ ngwaọrụ tanning. Ndị nwere ọtụtụ nevi, akụkọ ihe mere eme nke melanoma n’ezinaụlọ, yana ọrụ mgbochi na-adịghị mma, nọ n’ihe ize ndụ dị ukwuu maka melanoma.

Iji kpuchido onwe gị pụọ n’anwụ ma zere ìhè UV nwere ike igbochi melanoma. A na-eme ọgwụgwọ site n’ịwa ahụ. N’ime ndị nwere kansa dị ntakịrị, a na-enyocha lymph nodes dị nso maka metastasis. A na-agwọ ọtụtụ ndị ọrịa ma ọ bụrụ na metastasis adịghị. Maka ndị melanoma gbasasịrị, immunotherapy, ọgwụgwọ na-edozi ndụ, radieshon, ma ọ bụ chemotherapy nwere ike ime ka ndụ dịkwuo mma. Site n’ịgwọ, ọnụọgụ ndụ afọ ise na United States bụ 99 % n’ime ndị nwere melanoma mpaghara, 65 % n’ime ndị nwere metastasis n’lymph nodes, na 25 % n’ime ndị nwere metastasis dị anya.

Melanoma bụ ụdị kansa anụ ahụ kachasị ize ndụ. Ọstrelia na New Zealand nwere ọnụ ọgụgụ melanoma kachasị elu n’ụwa. Ọnụ ọgụgụ dị elu nke melanoma na-eme na Northern Europe na North America. Melanoma na-etolite obere na Asia, Africa, na Latin America. Na United States, melanoma na-apụta ihe dị ka ugboro 1.6 karịa n’ime ụmụ nwoke karịa ụmụ nwanyị.

Akara na Ihe Nkọwa
Ihe ịrịba ama mbụ nke melanoma bụ mgbanwe n’ụdị ma ọ bụ agba nke nevi dị adị. N’ihe gbasara nodular melanoma, ọ na-apụta dị ka ụda ọhụrụ n’akpụkpọ ahụ. N’oge melanoma na-esote, nevi nwere ike ịcha, ọnya, ma ọ bụ ọbara ọgbụgba.

[A‑Asymmetry] Asymmetry nke ọdịdị
[B‑Borders] Oke (nke na-adịghị agbanwe agbanwe n’akụkụ)
[C‑Color] Agba (dị iche ma ọ bụ na-adịghị agbanwe agbanwe)
[D‑Diameter] Dayameta (karịa 6 mm = 0.24 inch = ihe dị ka nha pensụl nchapu)
[E‑Evolving] Na-etolite ka oge na-aga

cf) Seborrheic keratosis nwere ike izute ụfọdụ ma ọ bụ ihe niile nke ABCD, ma nwee ike ibute ụjọ ụgha.

Metastasis site na mmalite melanoma nwere ike ime, mana ọ dịtụghị elu; ihe na-erughị otu ụzọ n’ime ise (≈20 %) nke melanoma a chọpụtara n’oge mbụ na-eme metastatic. A na-ahụkarị metastasis n’ụbụrụ n’ime ndị nwere melanoma metastatic. Metastatic melanoma nwekwara ike gbasaa n’imeju, ọkpụkpụ, afọ, ma ọ bụ lymph nodes dị anya.

Diagnosis
Nleba anya n’akụkụ a bụ usoro a na‑ejikarị enyocha melanoma. A na‑eleba anya nevi ndị na‑agbanwe agbanwe n’agba ma ọ bụ ọdịdị dịka ihe nwere ike ịghọ melanoma.
Ndị dibịa bekee na‑enyocha anụ ahụ niile, gụnyere nevi ndị nwere dayameta erughị 6 mm. Mgbe ndị ọkachamara jiri dermoscopy, ha nwere ike ịchọpụta ọnya ọjọọ karịa site n’ịlele anya naanị. Nchọpụta a na‑eme site na biopsy nke ọnya akpụkpọ ọ bụla nwere ihe ịrịba ama nke nwere ike ịkpata kansa.

Ọgwụgwọ
#Mohs surgery

Dọkịta gị nwere ike ịkwado immunotherapy karịsịa ma ọ bụrụ na ị nwere ogbo 3 ma ọ bụ ogbo 4 melanoma nke enweghị ike iwepụ ya na ịwa ahụ.
#Ipilimumab [Yervoy]
#Pembrolizumab [Keytruda]
#Nivolumab [Opdivo]
☆ AI Dermatology — Free Service
Na nsonaazụ Stiftung Warentest nke 2022 sitere na Germany, afọ ojuju ndị ahịa na ModelDerm dị ntakịrị ntakịrị karịa na nyocha telemedicine akwụ ụgwọ.
  • Melanoma nke ihe dịka 2.5 cm (1 inch) na 1.5 cm (0.6 inch)
  • Melanoma na-adịghị mma – apụta n’etiti aka nri. Enwere ike iwere seborrheic keratosis dị ka nchọpụta dị iche.
  • Malignant Melanoma in situ ― Ubu ihu. Ọ bụ ezie na ọdịdị nke ọnyá ahụ bụ asymmetric, a na-akọwa ya nke ọma n'agbanyeghị agba. N’ọtụtụ ndị Asia, ọnya ndị a na-adịkarị ka lentigo benign, mana a ga-eme biopsy n’ụlọ ọgwụ ndị bi n’Ebe Ọdịda Anyanwụ.
  • Melanoma na-adịghị mma – ọnya azụ. Na ndị Eshia, a na-ahụkarị ya dịka lentigo, mana a na-eme biopsy n’ụlọ ọgwụ ndị Western.
  • Nnukwu acral lentiginous melanoma — na Asia, acral melanoma n'ogbe aka na ụkwụ bụ ihe a na-ahụkarị, ebe ndị mmadụ n'ógbè ọdịda anyanwụ, melanoma na mpaghara anwụ na-apụtakarị.
  • Plaque ojii dị nro gburugburu ọnya bụ ihe a na-ahụkarị na acral melanoma.
  • Ebe ojii nke gbasasịrị n'ógbè matrix n'èzí ntu na-egosi na ọ dị njọ.
  • Amelanotic melanoma n'okpuru ntu bụ ihe na-adịghị ahụkebe. Maka ndị agadi nwere nrụrụ ntu mgbe niile, enwere ike ịtụle biopsy iji lelee ma ọ bụ melanoma ma ọ bụ squamous cell carcinoma.
  • Nodular melanoma
  • Amelanotic Melanoma - apụta ụkwụ azụ. Ndị nwere akpụkpọ ahụ mara mma na-enwekarị ọnya lightly pigmented ma ọ bụ amelanotic melanomas. Ikpe a anaghị egosi mgbanwe agba ma ọ bụ mgbanwe dị mfe nke a na-ahụ anya.
  • Scalp ― N'Asia, a na-ahụkarị ụdị ikpe a dị ka lentigo benign (ọ bụghị melanoma). Otú ọ dị, nnukwu patches nwere pigmented n'ọnụ ebe anwụ na-ekpuchi chọrọ biopsy n'ókèala ndị bi n'Ebe Ọdịda Anyanwụ.
  • Melanoma na-adịghị mma – n'ogwe aka. Ọnya ahụ na-egosipụta ọdịdị asymmetric na oke na-adịghị mma.
  • Malignant Melanoma in situ — ogwe aka.
  • Melanoma na-adịghị mma n'azụ. Ọnụnọ nke ihe mgbochi ọnya na-egosi melanoma ma ọ bụ basal cell carcinoma.
  • Melanoma n' ụkwụ. Ụdị na agba ya bụ asymmetrical, yana mbufụt na-eso ya, nke na-atụ aro melanoma.
  • Acral melanoma — Ntu n'Eshia. Ngwunye ojii na-adịghị ahụkebe nke na-agbatị karịa akpụkpọ ahụ nkịtị n'akụkụ ntu ahụ bụ nchọpụta dị mkpa nke na-egosi ọrịa siri ike.
  • Ọ bụ ezie na a chọpụtara ikpe a dị ka melanoma, ihe a na-ahụ anya yiri hematoma ntu. Ntu hematomas (benign) na-apụkarị n'ime otu ma ọ bụ ọnwa abụọ, a na‑achụpụ ha. Ya mere, ọ bụrụ na ọnya ahụ adịgide ogologo oge, a ga‑enyocha maka melanoma ma mee biopsy.
  • Amelanotic nodular melanoma ― Ngosipụta nke melanoma nodular na-enweghị melanin.
References Malignant Melanoma 29262210 
NIH
Melanoma bụ ụdị akpụkpọ nke na-etolite mgbe melanocytes na-aghọ njọ. Melanocytes na-esite na neural crest (crest neural). Nke a pụtara na melanoma nwere ike ịmalite ọ bụghị naanị na akpụkpọ ahụ kamakwa n'ebe ndị ọzọ ebe mkpụrụ ndụ crest na-eme njem, dị ka eriri afọ na ụbụrụ. Ndị ọrịa nwere ogbo 0 melanoma nwere ọnụọgụ ndụ afọ ise nke 97%, ebe ndị nwere ogbo IV nwere ọnụọgụ nke naanị ihe dịka 10%.
A melanoma is a tumor produced by the malignant transformation of melanocytes. Melanocytes are derived from the neural crest; consequently, melanomas, although they usually occur on the skin, can arise in other locations where neural crest cells migrate, such as the gastrointestinal tract and brain. The five-year relative survival rate for patients with stage 0 melanoma is 97%, compared with about 10% for those with stage IV disease.
 European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics: Update 2022 35570085
Cutaneous melanoma (CM) bụ ụdị etuto anụ ahụ dị ize ndụ, nke na-akpata 90 % nke kansa anụ ahụ. Iji dozie nke a, ndị ọkachamara sitere na European Dermatology Forum (EDF), European Association of Dermato‑Oncology (EADO), na European Organization for Research and Treatment of Cancer (EORTC) ejikọtala ọnụ.
Cutaneous melanoma (CM) is a highly dangerous type of skin tumor, responsible for 90% of skin cancer deaths. To address this, experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC) had collaborated.
 Immunotherapy in the Treatment of Metastatic Melanoma: Current Knowledge and Future Directions 32671117 
NIH
Melanoma, bụ́ ụdị ọrịa kansa anụ ahụ, pụtara maka mmekọrịta chiri anya ya na usoro ahụ ji alụso ọrịa ọgụ. Nke a pụtara ìhè site n’ịdị elu nke melanoma n’ime ndị nwere usoro ahụ ji alụso ọrịa ọgụ adịghị ike, site n’ọnụnọ mkpụrụ ndụ na-alụso ọrịa ọgụ, yana etuto mbụ na mgbasa ha n’akụkụ ahụ ndị ọzọ. Eziokwu ahụ bụ na usoro ahụ ji alụso ọrịa ọgụ nwere ike ịmata ụfọdụ protein dị na mkpụrụ ndụ melanoma. N'ụzọ dị mkpa, ọgwụgwọ ndị na-ebuli usoro ahụ ji alụso ọrịa ọgụ egosila nkwa n'ịlụso melanoma ọgụ. Ọ bụ ezie na iji usoro ọgwụgwọ na-akwalite ahụ ike n'ịgwọ melanoma dị elu bụ mmepe ọhụrụ, nchọpụta ọhụrụ na-egosi na ijikọta ọgwụ ndị a na chemotherapy, radiotherapy, ma ọ bụ ọgwụgwọ molekụla ezubere iche nwere ike ime ka nsonaazụ ka mma. Otú ọ dị, immunotherapy dị otú ahụ nwere ike ịkpalite mmetụta dị iche iche na-emetụta usoro ahụ ji alụso ọrịa ọgụ n’akụkụ ahụ dị iche iche, nke nwere ike igbochi ojiji ya. N'ile anya n'ihu, ụzọ ọdịnihu maka ịgwọ melanoma dị elu nwere ike ịgụnye ọgwụgwọ ndị na-elekwasị anya kpọmkwem n’egbochi PD1, ma ọ bụ ọgwụ ndị na-egbochi ụzọ molekụla dịka BRAF na MEK.
Melanoma is one of the most immunologic malignancies based on its higher prevalence in immune-compromised patients, the evidence of brisk lymphocytic infiltrates in both primary tumors and metastases, the documented recognition of melanoma antigens by tumor-infiltrating T lymphocytes and, most important, evidence that melanoma responds to immunotherapy. The use of immunotherapy in the treatment of metastatic melanoma is a relatively late discovery for this malignancy. Recent studies have shown a significantly higher success rate with combination of immunotherapy and chemotherapy, radiotherapy, or targeted molecular therapy. Immunotherapy is associated to a panel of dysimmune toxicities called immune-related adverse events that can affect one or more organs and may limit its use. Future directions in the treatment of metastatic melanoma include immunotherapy with anti-PD1 antibodies or targeted therapy with BRAF and MEK inhibitors.