Malignant melanoma - I-Melanoma Enobungozi
☆ Kwiziphumo zika-2022 ze-Stiftung Warentest ezivela eJamani, ukwaneliseka kwabathengi ngeModelDerm bekungaphantsi kancinci kunokubonisana nge-telemedicine ehlawulweyo.
I-melanoma emalunga ne-2.5cm (1 intshi) ngo-1.5cm (0.6 intshi)
Nangona le meko yafunyaniswa njenge-melanoma, ukufunyaniswa okubonakalayo kufana kakhulu ne-hematoma ye-nail. I-hematomas yezikhonkwane (benign) idla ngokunyamalala kwisithuba senyanga enye ukuya kwezimbini njengoko ikhutshelwa ngaphandle. Ngoko ke, ukuba isilonda sihlala ixesha elide, i-melanoma inokukrokra kwaye i-biopsy kufuneka yenziwe.
References
I-melanoma luhlobo lwethumba elenzeka xa i-melanocytes iba yingozi. I-Melanocytes ivela kwi-neural crest. Oku kuthetha ukuba i-melanomas ayinakukhula kuphela eluswini kodwa nakwezinye iindawo apho iiseli ze-neural crest zihamba khona, njengephecana lesisu kunye nengqondo. Izigulana ezinenqanaba le-0 melanoma zinezinga lokusinda leminyaka emihlanu lama-97%, kanti abo banesifo senqanaba le-IV banomlinganiselo omalunga ne-10% kuphela.
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) luhlobo oluyingozi kakhulu lwethumba lolusu, elinoxanduva lokufa komhlaza wolusu i90%. Ukulungisa oku, iingcaphephe ezisuka kwi the European Dermatology Forum (EDF) , the European Association of Dermato-Oncology (EADO) , and the European Organization for Research and Treatment of Cancer (EORTC) ziye zasebenzisana.
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.
I<em>melanoma, uhlobo lomhlaza wolusu, ibalasele ngolwalamano olusondeleyo nenkqubo yomzimba yokuzikhusela. Oku kubonakala kukwanda kokwenzeka kwayo kubantu abanamajoni omzimba abuthathaka, ubukho beeseli zokhuselo lomzimba kuwo omabini amathumba okuqala kunye nokusasazeka kwawo kwamanye amalungu omzimba, kunye nenyaniso yokuba amajoni omzimba anokuqonda iiproteni ezithile ezifumaneka kwiiseli zemelanoma. Okubalulekileyo, unyango olomeleza amajoni omzimba lubonise isithembiso ekulweni nemelanoma. Ngelixa ukusetyenziswa konyango lokomeleza i-immune ekuphatheni i-melanoma ephezulu luphuhliso lwamva nje, uphando lwakutsha nje lubonisa ukuba ukudibanisa olu nyango kunye ne-chemotherapy, i-radiotherapy, okanye unyango olujoliswe kuyo lweemolekyuli lunokuphucula kakhulu iziphumo. Nangona kunjalo, i-immunotherapy enjalo inokubangela uluhlu lweziphumo ebezingalindelekanga ezinxulumene nomzimba ezichaphazela izitho ezahlukeneyo, ezinokunciphisa ukusetyenziswa kwayo. Ukujonga phambili, iindlela ezizayo zokunyanga imelanoma ephucukileyo zinokubandakanya unyango olujolise kwiindawo ezithile zokugonywa komzimba ezifana ne-PD1, okanye amachiza aphazamisana neendlela ezithile zeemolekyuli ezifana ne-BRAF kunye ne-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.
Oyena nobangela uphambili wemelanoma kukuvezwa kokukhanya kweultraviolet kwabo banamanqanaba asezantsi ebala lesikhumba imelanin (abemi abamhlophe). Ukukhanya kwe-UV kusenokuba kuvela elangeni okanye kwizixhobo zokutshisa. Abo bane-nevus ezininzi, imbali ye-melanoma yamalungu osapho, kunye nokungasebenzi kakuhle kwamajoni omzimba basengozini enkulu ye-melanoma.
Ukusebenzisa i-sunscreen kunye nokuphepha ukukhanya kwe-UV kunokuthintela i-melanoma. Unyango ludla ngokususwa ngotyando. Kwezo zinemihlaza emikhudlwana, ii-lymph nodes ezikufutshane zinokuvavanyelwa ukusasazeka (metastasis). Uninzi lwabantu luyanyangeka ukuba i-metastasis ayizange yenzeke. Kwabo basasazeke kubo i-melanoma, i-immunotherapy, unyango lwe-biologic, unyango lwe-radiation, okanye i-chemotherapy inokuphucula ukusinda. Ngonyango, amazinga okusinda kweminyaka emihlanu e-United States yi-99% phakathi kwabo banesifo sendawo, i-65% xa isifo sisasazekile kwii-lymph nodes, kunye ne-25% phakathi kwabo basasazeka kude.
Imelanoma lolona hlobo luyingozi lomhlaza wolusu. IOstreliya neNew Zealand zinezinga eliphezulu lemelanoma ehlabathini. Amazinga aphezulu emelanoma ayenzeka kuMntla Yurophu nakuMntla Melika. Imelanoma ayifumaneki kangako eAsia, eAfrika naseLatin America. EUnited States, imelanoma yenzeke malunga nezihlandlo ezili-1,6 kumadoda kunamabhinqa.
○ Iimpawu kunye neempawu
Iimpawu zokuqala ze-melanoma lutshintsho kwimilo okanye kumbala we-nevus ekhoyo. Kwimeko ye-nodular melanoma, kukubonakala kweqhuma elitsha esikhumbeni. Kwinqanaba lokugqibela le-melanoma, i-nevi inokurhawuzelelwa, ibe nesilonda, okanye yophe.
[A-Asymmetry] I-asymmetry yobume
[B-Borders] Umda (ngokungaqhelekanga kunye neekona kunye neekona)
[C-Color] Umbala (i-variegated kwaye ayiqhelekanga)
[D-Diameter] Ububanzi (ngaphezulu kwe-6 mm = 0.24 intshi = malunga nobukhulu bento yokucima ipensile)
[E-Evolving] Hlaziya ngokuhamba kwexesha
cf) I-Seborrheic keratosis inokuhlangabezana nezinye okanye zonke iikhrayitheriya ze-ABCD, kwaye inokukhokelela kwiialamu zobuxoki.
I-Metastasis ye-melanoma yokuqala inokwenzeka, kodwa inqabile; ngaphantsi kwesihlanu seemelanoma ezifunyaniswe kwangethuba zibe yimetastatic. Iimetastases zobuchopho zixhaphakile kwizigulane ezine-metastatic melanoma. I-Metastatic melanoma inokusasazeka kwisibindi, amathambo, isisu, okanye i-lymph nodes ezikude.
○ Uxilongo
Ukujonga indawo ekuthethwa ngayo yeyona ndlela ixhaphakileyo yokurhanela imelanoma. IiNevus ezingaqhelekanga ngombala okanye imilo zidla ngokuphathwa njengabagqatswa bemelanoma.
Oogqirha baphonononga zonke iimoles, kubandakanywa nezo zingaphantsi kwe-6 mm ububanzi. Xa isetyenziswe ziingcali eziqeqeshiweyo, i-dermoscopy inceda ngakumbi ukuchonga izilonda ezinobungozi kunokusebenzisa iliso lodwa. Uxilongo lwe-biopsy yaso nasiphi na isilonda solusu esineempawu zokuba sinokuba nomhlaza.
○ Unyango
#Mohs surgery
Ugqirha wakho unokuncoma i-immunotherapy ngakumbi ukuba unenqanaba lesi-3 okanye i-4 melanoma engenakususwa ngotyando.
#Ipilimumab [Yervoy]
#Pembrolizumab [Keytruda]
#Nivolumab [Opdivo]