Malignant melanoma
☆ Na nsonaazụ Stiftung Warentest nke 2022 sitere na Germany, afọ ojuju ndị ahịa na ModelDerm dị ntakịrị ntakịrị karịa na nyocha telemedicine akwụ ụgwọ.
A melanoma nke ihe dịka 2.5cm (1 inch) na 1.5cm (0.6 inch)
References
Melanoma bụ ụdị akpụ nke na-etolite mgbe melanocytes na-aghọ njọ. Melanocytes na-esite na 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 ọrịa IV nwere ọnụ ọgụgụ 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.
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.
Cutaneous melanoma (CM) bụ ụdị etuto anụ ahụ dị oke egwu, na-akpata 90% nke ọrịa kansa anụ ahụ. Iji dozie nke a, ndị ọkachamara sitere na the European Dermatology Forum (EDF) , the European Association of Dermato-Oncology (EADO) , and the 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.
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.
Melanoma, ụdị ọrịa kansa anụ ahụ, pụtara maka mmekọrịta chiri anya ya na usoro ahụ ji alụso ọrịa ọgụ. Nke a pụtara ìhè site na mmụba ya na ndị nwere usoro ahụ ji alụso ọrịa ọgụ adịghị ike, ọnụnọ nke mkpụrụ ndụ na-alụso ọrịa ọgụ na ma etuto mbụ na mgbasa ha na akụkụ ahụ ndị ọzọ, na eziokwu ahụ bụ na usoro ahụ ji alụso ọrịa ọgụ nwere ike ịmata ụfọdụ protein ndị 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 ọrịa melanoma dị elu bụ mmepe na-adịbeghị anya, nchọpụta na-adịbeghị anya na-egosi na ijikọta usoro ọgwụgwọ ndị a na chemotherapy, radiotherapy, ma ọ bụ ọgwụgwọ molekụla ezubere iche nwere ike ime ka ọ dịkwuo mma. Otú ọ dị, immunotherapy dị otú ahụ nwere ike ịkpalite mmetụta dị iche iche na-emetụta usoro ahụ ji alụso ọrịa ọgụ na-emetụta akụkụ ahụ dị iche iche, nke nwere ike igbochi ojiji ya. N'ile anya n'ihu, ụzọ ọdịnihu maka ịgwọ ọrịa melanoma dị elu nwere ike ịgụnye usoro ọgwụgwọ na-elekwasị anya kpọmkwem ebe nlele mgbochi dị ka PD1, ma ọ bụ ọgwụ ndị na-egbochi ụzọ molekụla dị ka 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.
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.
Isi ihe na-akpata melanoma bụ ìhè ultraviolet n'ime ndị nwere obere agba nke melanin pigmenti akpụkpọ ahụ (ọnụ ọgụgụ ndị ọcha). Ìhè UV nwere ike ịbụ site na anwụ ma ọ bụ ngwaọrụ tanning. Ndị nwere ọtụtụ nevus, akụkọ ihe mere eme nke melanoma nke ndị òtù ezinụlọ, yana ọrụ mgbochi na-adịghị mma nọ n'ihe ize ndụ dị ukwuu na melanoma.
Iji mkpuchi anwụ na izere ìhè UV nwere ike igbochi melanoma. A na-ewepụ ọgwụgwọ site n'ịwa ahụ. N'ime ndị nwere ọrịa kansa dị ntakịrị karịa, enwere ike ịnwale ọnụọgụ lymph dị nso maka ịgbasa ( metastasis). A na-agwọ ọtụtụ mmadụ ma ọ bụrụ na metastasis emeghị. Maka ndị melanoma gbasaara n'ime ha, immunotherapy, usoro ọgwụgwọ ndụ, ọgwụgwọ radieshon, ma ọ bụ chemotherapy nwere ike ime ka ndụ dịkwuo mma. Site na ọgwụgwọ, ọnụ ọgụgụ ndụ ndụ afọ ise na United States bụ 99% n'etiti ndị nwere ọrịa mpaghara, 65% mgbe ọrịa ahụ gbasaara na oghere lymph, yana 25% n'etiti ndị nwere mgbasa dị anya.
Melanoma bụ ụdị ọrịa kansa anụ ahụ kachasị dị ize ndụ. Ọstrelia na New Zealand nwere ọnụ ọgụgụ melanoma kachasị elu n'ụwa. Ọnụ ọgụgụ dị elu nke melanoma na-emekwa 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 ụmụ nwoke karịa ụmụ nwanyị.
○ akara na akara
Ihe ịrịba ama mbụ nke melanoma bụ mgbanwe n'ụdị ma ọ bụ agba nke nevus dị adị. N'ihe banyere nodular melanoma, ọ bụ ọdịdị nke ọkpụkpụ ọhụrụ na akpụkpọ ahụ. N'ime 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 na akụkụ na akụkụ)
[C-Color] Agba (dị iche na nke 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 njirisi, ma nwee ike ibute mkpu ụgha.
Metastasis nke mmalite melanoma ga-ekwe omume, mana ọ dị obere; Ihe na-erughị otu ụzọ n'ụzọ ise nke melanoma nke a chọpụtara n'oge na-aghọ metastatic. A na-ahụkarị metastases nke ụbụrụ na ndị ọrịa nwere melanoma metastatic. Metastatic melanoma nwekwara ike gbasaa na imeju, ọkpụkpụ, afọ, ma ọ bụ ọnụ ọgụgụ lymph dị anya.
○ Diagnosis
Ileba anya na mpaghara a na-ekwu okwu bụ usoro a na-ahụkarị nke na-enyo enyo melanoma. A na-emeso Nevus ndị na-adịghị agbanwe agbanwe na agba ma ọ bụ ọdịdị dị ka ndị na-aga melanoma.
Ndị dibịa bekee na-enyocha anụ ahụ niile, gụnyere ndị na-erughị 6 mm na dayameta. Mgbe ndị ọkachamara zụrụ azụ na-eji ya, dermoscopy na-enyere aka ịchọpụta ọnya ọjọọ karịa iji anya gba ọtọ naanị. Nchọpụta nchọpụta bụ site na biopsy nke ọnya akpụkpọ ọ bụla nwere ihe ịrịba ama nke nwere ike ịkpata ọrịa 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]