Malignant melanoma - Melanoma E Kotsi
☆ Liphethong tsa 2022 Stiftung Warentest tse tsoang Jeremane, khotsofalo ea bareki ka ModelDerm e ne e le tlase hanyane ho feta lipuisano tse lefelloang tsa telemedicine.
A melanoma e ka bang 2.5cm (1 inch) le 1.5cm (0.6 inch)
Le hoja nyeoe ena e ile ea fumanoa e le melanoma, pono e fumanoang e tšoana le hematoma ea manala. Nail hematomas (benign) hangata e nyamela nakong ea khoeli e le 'ngoe ho isa ho tse peli ha e ntse e sutumetsoa ka ntle. Ka hona, haeba leqeba le tsoela pele ka nako e telele, ho ka 'na ha belaelloa melanoma 'me ho lokela ho etsoa tlhahlobo ea biopsy.
References
Melanoma ke mofuta oa hlahala e hlahang ha melanocyte e e-ba kotsi. Melanocyte e tsoa ho neural crest. Sena se bolela hore melanoma e ka hlaha eseng letlalong feela empa hape le libakeng tse ling moo lisele tsa neural crest li tsamaeang teng, joalo ka pampitšana ea mala le boko. Bakuli ba nang le melanoma ea mohato oa 0 ba phela lilemo tse hlano tsa 97%, athe ba nang le lefu la mohato oa IV ba na le tekanyo ea hoo e ka bang 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) ke mofuta o kotsi haholo oa hlahala ea letlalo, e ikarabellang bakeng sa 90% ea mafu a mofetše oa letlalo. Ho rarolla bothata bona, litsebi tse tsoang ho the European Dermatology Forum (EDF) , the European Association of Dermato-Oncology (EADO) , and the European Organization for Research and Treatment of Cancer (EORTC) li sebelisane.
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, mofuta oa kankere ea letlalo, e ikhetha ka kamano ea eona e haufi le tsamaiso ea 'mele ea ho itšireletsa mafung. Sena se bonahala ka ho eketseha ha eona ho batho ba nang le tsamaiso ea 'mele ea ho itšireletsa mafung e fokolang, boteng ba lisele tsa' mele tsa ho itšireletsa mafung ka bobeli lihlahala tsa pele le ho ata ha tsona likarolong tse ling tsa 'mele, le taba ea hore sesole sa' mele se ka lemoha liprotheine tse itseng tse fumanoang liseleng tsa melanoma. Habohlokoa, liphekolo tse matlafatsang sesole sa 'mele li bontšitse tšepiso ea ho loantša melanoma. Le hoja tšebeliso ea liphekolo tse matlafatsang 'mele ho phekola melanoma e tsoetseng pele e le tsoelo-pele ea morao-rao, lipatlisiso tsa morao-rao li bontša hore ho kopanya mekhoa ena ea phekolo le chemotherapy, radiotherapy, kapa phekolo e lebisitsoeng ea limolek'hule ho ka ntlafatsa liphello haholo. Leha ho le joalo, immunotherapy e joalo e ka tsosa litla-morao tse ngata tse amanang le 'mele tse amang litho tse fapaneng, tse ka fokotsang tšebeliso ea eona. Ha re sheba pele, mekhoa ea kamoso ea ho alafa melanoma e tsoetseng pele e kanna ea kenyelletsa liphekolo tse shebaneng le libaka tsa tlhahlobo ea 'mele ea ho itšireletsa mafung joalo ka PD1, kapa lithethefatsi tse sitisang litsela tse itseng tsa limolek'hule joalo ka BRAF le 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.
Sesosa se ka sehloohong sa melanoma ke ho pepeseha ha leseli la ultraviolet ho ba nang le maemo a tlase a letlalo la letlalo melanin (ba basoeu). Leseli la UV e ka 'na eaba le tsoa letsatsing kapa lisebelisoa tsa ho fifala ha letlalo. Ba nang le li-nevus tse ngata, histori ea litho tsa lelapa la melanoma le ho fokola ha 'mele oa ho itšireletsa mafung ba kotsing e kholo ea ho tšoaroa ke melanoma.
Ho sebelisa setlolo se sireletsang letlalo letsatsing le ho qoba khanya ea UV ho ka thibela melanoma. Kalafo hangata e tlosoa ka ho buuoa. Ho ba nang le kankere e kholoanyane, li-lymph nodes tse haufi li ka 'na tsa lekoa bakeng sa ho ata (metastasis). Batho ba bangata baa phekoloa haeba metastasis e sa etsahala. Bakeng sa bao melanoma e atileng ho bona, immunotherapy, biologic therapy, radiation therapy, kapa chemotherapy e ka ntlafatsa bophelo. Ka phekolo, litekanyetso tsa lilemo tse hlano tsa ho phela United States ke 99% har'a ba nang le lefu la sebakeng seo, 65% ha lefu lena le nametse ho lymph nodes, le 25% har'a ba nang le tšoaetso e hōle.
Melanoma ke mofuta o kotsi ka ho fetisisa oa kankere ea letlalo. Australia le New Zealand li na le litekanyetso tse phahameng ka ho fetisisa tsa melanoma lefatšeng. Sekhahla se phahameng sa melanoma se boetse se etsahala Europe Leboea le Amerika Leboea. Melanoma ha e hlahe haholo Asia, Afrika le Latin America. United States, melanoma e hlaha hangata ka makhetlo a ka bang 1,6 ho banna ho feta basali.
○ Matshwao le matshwao
Matšoao a pele a melanoma ke liphetoho sebopeho kapa 'mala oa nevus e teng. Tabeng ea nodular melanoma, ke ponahalo ea lesela le lecha letlalong. Mehatong ea morao ea melanoma, nevi e ka 'na ea hlohlona, ea tsoa liso, kapa ea tsoa mali.
[A-Asymmetry] Asymmetry ea sebopeho
[B-Borders] Border (e sa tsitsang e nang le mahlakore le likhutlo)
[C-Color] Mmala (o fapaneng le o sa tloaelehang)
[D-Diameter] Diameter (e kholo ho feta 6 mm = 0.24 inch = e ka bang boholo ba raba ea pentšele)
[E-Evolving] Fetoha ka nako
cf) Seborrheic keratosis e ka kopana le tse ling kapa mekhoa eohle ea ABCD, 'me e ka lebisa litsing tsa bohata.
Metastasis ea melanoma ea pele e ka etsahala, empa e batla e sa tloaeleha; Ka tlase ho karolo ea bohlano ea melanoma e fumanoeng e sa le pele e fetoha metastatic. Metastase ea boko e tloaelehile ho bakuli ba nang le melanoma ea metastatic. Metastatic melanoma e ka boela ea namela sebeteng, masapong, mpeng kapa li- lymph nodes tse hōle.
○ Tlhahlobo
Ho sheba sebaka seo ho buuoang ka sona ke mokhoa o atileng haholo oa ho belaela melanoma. Li-Nevus tse sa tsitsang ka 'mala kapa sebopeho hangata li tšoaroa joalo ka melanoma.
Lingaka li atisa ho hlahloba li-moles tsohle, ho kenyelletsa le tse ka tlaase ho 6 mm ka bophara. Ha e sebelisoa ke litsebi tse koetlisitsoeng, dermoscopy e thusa haholo ho lemoha maqeba a kotsi ho feta ho sebelisa leihlo le hlobotseng feela. Tlhahlobo ke ka biopsy ea leqeba leha e le lefe la letlalo le nang le matšoao a ho ba le mofetše.
○ Kalafo
#Mohs surgery
Ngaka ea hau e ka 'na ea khothaletsa immunotherapy haholo-holo haeba u na le melanoma ea sethaleng sa 3 kapa sethaleng sa 4 se ke keng sa tlosoa ka ho buuoa.
#Ipilimumab [Yervoy]
#Pembrolizumab [Keytruda]
#Nivolumab [Opdivo]