Malignant melanoma - Melanoma Buburu
☆ Ninu awọn abajade 2022 Stiftung Warentest lati Jẹmánì, itẹlọrun alabara pẹlu ModelDerm jẹ kekere diẹ ju pẹlu awọn ijumọsọrọ telemedicine isanwo.
melanoma kan ti o to 2.5cm (inch 1) nipasẹ 1.5cm (0.6 inch)
References
A melanoma jẹ iru tumo ti o dagba nigbati awọn melanocytes di buburu. Melanocytes wa lati inu iṣan ti iṣan. Eyi tumọ si pe melanomas le dagbasoke kii ṣe lori awọ ara nikan ṣugbọn tun ni awọn aaye miiran nibiti awọn sẹẹli alakan ti nrin kiri, bii ikun ikun ati ọpọlọ. Awọn alaisan ti o ni ipele 0 melanoma ni oṣuwọn iwalaaye ọdun marun ti 97%, lakoko ti awọn ti o ni arun ipele IV ni iwọn nikan nipa 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) jẹ iru eewu ti o lewu pupọ ti tumọ awọ ara, lodidi fun 90% ti awọn iku alakan awọ. Lati koju eyi, awọn amoye lati the European Dermatology Forum (EDF) , the European Association of Dermato-Oncology (EADO) , and the European Organization for Research and Treatment of Cancer (EORTC) ti ṣe ifowosowopo.
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, iru kan ti akàn ara, duro jade fun ibatan ti o sunmọ pẹlu eto ajẹsara. Eyi han gbangba lati iṣẹlẹ ti o pọ si ni awọn eniyan ti o ni awọn eto ajẹsara ailagbara, wiwa awọn sẹẹli ajẹsara ninu mejeeji awọn èèmọ atilẹba ati itankale wọn si awọn ẹya miiran ti ara, ati otitọ pe eto ajẹsara le ṣe idanimọ awọn ọlọjẹ kan ti a rii ninu awọn sẹẹli melanoma. Ni pataki, awọn itọju ti o ṣe igbelaruge eto ajẹsara ti han ileri ni ija melanoma. Lakoko ti lilo awọn itọju ailera-igbelaruge ni ṣiṣe itọju melanoma to ti ni ilọsiwaju jẹ idagbasoke aipẹ, iwadii aipẹ tọka pe apapọ awọn itọju ailera wọnyi pẹlu chemotherapy, radiotherapy, tabi awọn itọju molikula ti a fojusi le mu awọn abajade dara si. Sibẹsibẹ, iru imunotherapy le fa ọpọlọpọ awọn ipa ẹgbẹ ti o ni ibatan ajẹsara ti o ni ipa lori ọpọlọpọ awọn ara, eyiti o le dinku lilo rẹ. Wiwa iwaju, awọn isunmọ ọjọ iwaju fun atọju melanoma to ti ni ilọsiwaju le kan awọn itọju ti o fojusi awọn aaye ayẹwo ajẹsara kan pato bi PD1, tabi awọn oogun ti o dabaru pẹlu awọn ipa ọna molikula kan bi BRAF ati 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.
Idi akọkọ ti melanoma jẹ ifihan ina ultraviolet ninu awọn ti o ni awọn ipele kekere ti melanin pigment awọ (olugbe funfun). Ina UV le jẹ lati oorun tabi awọn ẹrọ soradi. Awọn ti o ni ọpọlọpọ nevus, itan-akọọlẹ melanoma ti awọn ọmọ ẹgbẹ ẹbi, ati iṣẹ ajẹsara ti ko dara wa ni ewu nla ni melanoma.
Lilo iboju-oorun ati yago fun ina UV le ṣe idiwọ melanoma. Itọju jẹ igbagbogbo yiyọ kuro nipasẹ iṣẹ abẹ. Ninu awọn ti o ni awọn alakan ti o tobi diẹ sii, awọn apa ọmu-ara ti o wa nitosi le ni idanwo fun itankale (metastasis). Pupọ eniyan ni a mu larada ti metastasis ko ba waye. Fun awọn ti melanoma ti tan kaakiri, imunotherapy, itọju ailera isedale, itọju itanjẹ, tabi chemotherapy le mu iwalaaye dara si. Pẹlu itọju, awọn oṣuwọn iwalaaye ọdun marun ni Ilu Amẹrika jẹ 99% laarin awọn ti o ni arun agbegbe, 65% nigbati arun na ti tan si awọn apa-ọpa, ati 25% laarin awọn ti o ni itankale jijinna.
Melanoma jẹ iru alakan awọ ti o lewu julọ. Australia ati Ilu Niu silandii ni awọn oṣuwọn melanoma ti o ga julọ ni agbaye. Awọn oṣuwọn giga ti melanoma tun waye ni Ariwa Yuroopu ati Ariwa America. Melanoma waye diẹ sii ni Asia, Afirika, ati Latin America. Ni Orilẹ Amẹrika, melanoma waye nipa awọn akoko 1.6 diẹ sii nigbagbogbo ninu awọn ọkunrin ju awọn obinrin lọ.
○ Ami ati awọn aami aisan
Awọn ami ibẹrẹ ti melanoma jẹ awọn iyipada si apẹrẹ tabi awọ ti nevus ti o wa tẹlẹ. Ninu ọran ti melanoma nodular, o jẹ ifarahan ti odidi tuntun lori awọ ara. Ni awọn ipele nigbamii ti melanoma, nevi le yun, ọgbẹ, tabi ẹjẹ.
[A-Asymmetry] Asymmetry ti apẹrẹ
[B-Borders] Aala (aiṣedeede pẹlu awọn egbegbe ati awọn igun)
[C-Color] Awọ (orisirisi ati alaibamu)
[D-Diameter] Opin (tobi ju 6 mm = 0.24 inch = nipa iwọn ti eraser ikọwe)
[E-Evolving] Dagba lori akoko
cf) Seborrheic keratosis le pade diẹ ninu awọn tabi gbogbo awọn ilana ABCD, ati pe o le ja si awọn itaniji eke.
Metastasis ti melanoma tete ṣee ṣe, ṣugbọn o ṣọwọn pupọ; kere ju idamarun ti melanomas ti a ṣe ayẹwo ni kutukutu di metastatic. Awọn metastases ọpọlọ jẹ wọpọ ni awọn alaisan ti o ni melanoma metastatic. Metastatic melanoma tun le tan si ẹdọ, awọn egungun, ikun, tabi awọn apa ti o jinna.
○ Ayẹwo aisan
Wiwo agbegbe ti o wa ni ibeere jẹ ọna ti o wọpọ julọ ti ifura kan melanoma. Nevus ti ko ṣe deede ni awọ tabi apẹrẹ ni a ṣe itọju nigbagbogbo bi awọn oludije ti melanoma.
Awọn oniwosan ṣe ayẹwo gbogbo awọn moles, pẹlu eyiti o kere ju milimita 6 ni iwọn ila opin. Nigba lilo nipasẹ awọn alamọja ti oṣiṣẹ, dermoscopy jẹ iranlọwọ diẹ sii lati ṣe idanimọ awọn egbo buburu ju lilo oju ihoho nikan. Ayẹwo aisan jẹ nipasẹ biopsy ti eyikeyi ọgbẹ ara ti o ni awọn ami ti jijẹ alakan.
○ Itọju
#Mohs surgery
Dọkita rẹ le ṣeduro imunotherapy paapaa ti o ba ni ipele 3 tabi ipele 4 melanoma ti ko le yọ kuro pẹlu iṣẹ abẹ.
#Ipilimumab [Yervoy]
#Pembrolizumab [Keytruda]
#Nivolumab [Opdivo]