Malignant melanoma - Yakaipa Melanoma
☆ Mune 2022 Stiftung Warentest mhedzisiro kubva kuGermany, kugutsikana kwevatengi neModelDerm kwakangodzikira zvishoma pane nekubhadharwa kwe telemedicine kubvunzana.
A melanoma inosvika 2.5cm (1 inch) ne1.5cm (0.6 inch)
Kunyangwe iyi nyaya yakaonekwa semelanoma, kuwanikwa kwekuona kwakafanana nehematoma yechipikiri. Chipikiri hematomas (benign) kazhinji inonyangarika mukati memwedzi mumwe kusvika miviri pavanenge vachisundirwa kunze. Saka, kana chironda chikaramba chiripo kwenguva yakareba, melanoma inogona kufungidzirwa uye biopsy inofanira kuitwa.
References
A melanoma imhando yebundu rinoumbwa kana melanocyte ikava yakaipa. Melanocytes anobva kuNeural crest. Izvi zvinoreva kuti melanomas inogona kukura kwete paganda chete asiwo mune dzimwe nzvimbo dzinofamba neural crest masero, senge gastrointestinal turakiti uye uropi. Varwere vane nhanho 0 melanoma vane makore mashanu ekupona kwe97%, nepo avo vane chirwere chedanho IV vane mwero we10% chete.
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) imhando ine njodzi yebundu reganda, inokonzera makumi mapfumbamwe muzana ekufa kwegomarara reganda. Kuti zvigadzirise izvi, nyanzvi kubva ku the European Dermatology Forum (EDF) , the European Association of Dermato-Oncology (EADO) , and the European Organization for Research and Treatment of Cancer (EORTC) dzakanga dzashanda.
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, rudzi rwegomarara reganda, rakatanhamara nokuda kwoukama hwayo hwepedyo negadziriro yomuviri inodzivirira zvirwere. Izvi zvinoonekwa kubva mukuwedzera kwayo muvanhu vane immune system isina simba, kuvepo kwemasero edziviriro mumamota ekutanga uye kupararira kwavo kune dzimwe nzvimbo dzemuviri, uye chokwadi chekuti immune system inogona kuziva mamwe mapuroteni anowanikwa mumaseru emelanoma. Zvakakosha, marapirwo anosimudzira immune system kwakaratidza vimbiso mukurwisa melanoma. Nepo kushandiswa kwemishonga inosimudzira immune mukurapa melanoma yakakura ichangoburwa, tsvakiridzo ichangoburwa inoratidza kuti kubatanidza marapirwo aya nechemotherapy, radiotherapy, kana marapirwo anonangwa nemamolecular anogona kuvandudza mhedzisiro. Nekudaro, immunotherapy yakadaro inogona kukonzeresa huwandu hwemhedzisiro ine chekuita nemuviri inobata nhengo dzakasiyana-siyana, iyo inogona kudzikamisa kushandiswa kwayo. Tichitarisa kumberi, nzira dzeramangwana dzekurapa melanoma yepamusoro dzinogona kusanganisira marapiro anonangana nenzvimbo dzekudzivirira zvirwere sePD1, kana zvinodhaka zvinokanganisa nzira dzakaita seBRAF neMEK.
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.
Chikonzero chikuru che melanoma is ultraviolet light exposure kune avo vane mazinga akaderera eganda pigment melanin (vachena). Chiedza cheUV chinogona kubva kuzuva kana midziyo yekupisa. Avo vane manevus akawanda, nhoroondo yemelanoma yenhengo dzemhuri, uye kusashanda zvakanaka kwekudzivirirwa kwezvirwere mumuviri vari panjodzi huru yemelanoma.
Kushandisa sunscreen uye kudzivirira UV mwenje kunogona kudzivirira melanoma. Kurapa kunowanzo kubviswa nekuvhiyiwa. Mune avo vane kenza yakakura zvishoma, lymph nodes dziri pedyo dzinogona kuongororwa kupararira (metastasis). Vanhu vazhinji vanorapwa kana metastasis isati yaitika. Kune avo vane melanoma yakapararira, immunotherapy, biologic therapy, radiation therapy, kana chemotherapy inogona kuvandudza kupona. Nekurapwa, makore mashanu ekupona muUnited States ari 99% pakati peavo vane chirwere chenzvimbo, 65% kana chirwere ichi chapararira kune lymph nodes, uye 25% pakati peavo vane kupararira kure.
Melanoma imhando ine njodzi zvakanyanya yegomarara reganda. Australia neNew Zealand dzine mwero wepamusoro we melanoma pasi rose. Mwero yakakwirira ye melanoma inowanikwawo muNorthern Europe neNorth America. Melanoma inowanikwa zvishoma muAsia, Africa, uye Latin America. MuUnited States, melanoma inoitika kanenge ka1,6 kakawanda muvarume kupfuura vakadzi.
○ Zviratidzo uye zviratidzo
Zviratidzo zvekutanga zve melanoma kuchinja kune chimiro kana ruvara rwenevus iripo. Panyaya ye nodular melanoma, ndiko kutaridzika kwebundu idzva paganda. Pamatanho ekupedzisira e melanoma, nevi inogona kukwenya, ronda, kana kubuda ropa.
[A-Asymmetry] Asymmetry yechimiro
[B-Borders] Border (isina kurongeka nemicheto nemakona)
[C-Color] Ruvara (variegated uye irregular)
[D-Diameter] Diameter (yakakura kupfuura 6 mm = 0.24 inch = inenge saizi yepenzura eraser)
[E-Evolving] Evolve nekufamba kwenguva
cf) Seborrheic keratosis inogona kusangana nezvimwe kana zvese zveABCD maitiro, uye inogona kutungamirira kumaalarm enhema.
Metastasis yekutanga melanoma inogoneka, asi isingawanzo; isingasviki chikamu chimwe chete muzvishanu che melanomas akaonekwa achangotanga kuita metastatic. Brain metastases inowanzoitika kune varwere vane metastatic melanoma. Metastatic melanoma inogonawo kupararira kuchiropa, mapfupa, dumbu, kana kure kure lymph nodes.
○ Chirwere
Kutarisa nzvimbo iri kutaurwa ndiyo nzira yakajairika yekufungira melanoma. Nevus iyo isina kurongeka muruvara kana chimiro inowanzobatwa sevanomirira melanoma.
Vanachiremba vanowanzo ongorora ma moles ese, kusanganisira asingasviki 6 mm muhupamhi. Kana yakashandiswa nenyanzvi dzakadzidziswa, dermoscopy inobatsira zvikuru kuziva maronda akaipa pane kushandisa ziso chete. Kuongororwa kunoitwa nebiopsy yechero chironda cheganda chine zviratidzo zvekugona kuita gomarara.
○ Kurapa
#Mohs surgery
Chiremba wako anogona kukurudzira immunotherapy kunyanya kana uine nhanho 3 kana nhanho 4 melanoma isingabviswe nekuvhiyiwa.
#Ipilimumab [Yervoy]
#Pembrolizumab [Keytruda]
#Nivolumab [Opdivo]