Malignant melanoma - I-Melanoma Eyingozi
☆ Emiphumeleni ka-2022 ye-Stiftung Warentest evela eJalimane, ukwaneliseka kwabathengi nge-ModelDerm bekungaphansi kancane kunokuxhumana okukhokhelwayo kwe-telemedicine.
I-melanoma cishe engu-2.5cm (1 intshi) ngo-1.5cm (0.6 intshi)
Nakuba lesi sigameko sitholwe njenge-melanoma, okutholakele kufana kakhulu ne-hematoma yezinzipho. I-hematomas yezinzipho (benign) ivamise ukunyamalala phakathi nenyanga eyodwa kuya kwezimbili njengoba iphushwa ngaphandle. Ngakho-ke, uma isilonda siqhubeka isikhathi eside, kungase kusolwe i-melanoma futhi kwenziwe i-biopsy.
References
I-melanoma wuhlobo lwesimila olwakha lapho ama-melanocyte eba yingozi. Ama-melanocyte avela ku-neural crest. Lokhu kusho ukuthi i-melanoma ingakwazi ukukhula hhayi esikhumbeni kuphela kodwa nakwezinye izindawo lapho amangqamuzana e-neural crest ehamba khona, njengepheshana lamathumbu nobuchopho. Iziguli ezine-stage 0 melanoma zinezinga lokusinda leminyaka emihlanu lama-97%, kanti lezo ezinesifo sesigaba IV zinezinga elilinganiselwa ku-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) wuhlobo oluyingozi kakhulu lwesimila sesikhumba, olubangela u-90% wokufa komdlavuza wesikhumba. Ukuze kubhekwane nalokhu, ochwepheshe abavela ku- the European Dermatology Forum (EDF) , the European Association of Dermato-Oncology (EADO) , and the European Organization for Research and Treatment of Cancer (EORTC) babambisene.
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-Melanoma, uhlobo lomdlavuza wesikhumba, igqama ngobuhlobo bayo obuseduze nesimiso somzimba sokuzivikela ezifweni. Lokhu kubonakala ngokwanda kwayo kubantu abanamasosha omzimba abuthaka, ukuba khona kwamangqamuzana omzimba kuwo womabili amathumba okuqala nokusabalala kwawo kwezinye izingxenye zomzimba, kanye neqiniso lokuthi amasosha omzimba angakwazi ukubona amaprotheni athile atholakala kumangqamuzana e-melanoma. Okubalulekile, ukwelashwa okuqinisa isimiso somzimba sokuzivikela ezifweni kubonise isithembiso ekulweni ne-melanoma. Nakuba ukusetshenziswa kwemithi yokuqinisa amasosha omzimba ekwelapheni i-melanoma ethuthukisiwe kuyintuthuko yamuva nje, ucwaningo lwakamuva lubonisa ukuthi ukuhlanganisa lezi zindlela zokwelapha ngamakhemikhali, i-radiotherapy, noma ukwelashwa kwamangqamuzana okuhlosiwe kungayithuthukisa kakhulu imiphumela. Kodwa-ke, i-immunotherapy enjalo ingabangela uhla lwemiphumela emibi ehlobene nokuzivikela komzimba ethinta izitho ezihlukahlukene, ezingase zinciphise ukusetshenziswa kwayo. Uma ubheka phambili, izindlela zesikhathi esizayo zokwelapha i-melanoma ethuthukisiwe zingase zibandakanye izindlela zokwelapha eziqondiswe ezindaweni ezithile zokuhlola amasosha omzimba njenge-PD1, noma izidakamizwa eziphazamisa izindlela ezithile zamangqamuzana njenge-BRAF 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.
Imbangela eyinhloko ye-melanoma ukuchayeka ekukhanyeni kwe-ultraviolet kulabo abanamazinga aphansi e-pigment pigment melanin (abantu abamhlophe). Ukukhanya kwe-UV kungase kube okuvela elangeni noma emishinini yokushukwa kwesikhumba. Labo abane-nevus eminingi, umlando we-melanoma wamalungu omndeni, kanye nokungasebenzi kahle kwamasosha omzimba basengozini enkulu ye-melanoma.
Ukusebenzisa i-sunscreen nokugwema ukukhanya kwe-UV kungase kuvimbele i-melanoma. Ukwelashwa ngokuvamile kususwa ngokuhlinzwa. Kulawo anomdlavuza emikhudlwana, ama-lymph nodes aseduze angase ahlolelwe ukusabalala (i-metastasis). Abantu abaningi bayelapheka uma i-metastasis ingenzeki. Kulabo okusabalale kubo i-melanoma, i-immunotherapy, i-biologic therapy, i-radiation therapy, noma i-chemotherapy ingase ithuthukise ukusinda. Ngokwelashwa, amazinga okusinda kweminyaka emihlanu e-United States angama-99% kulabo abanesifo sendawo, ama-65% lapho lesi sifo sesisakazekele kuma-lymph nodes, kanye nama-25% kulabo abanokusabalala okukude.
I-melanoma uhlobo oluyingozi kakhulu lomdlavuza wesikhumba. I-Australia neNew Zealand banamazinga aphezulu kakhulu e-melanoma emhlabeni. Amazinga aphezulu e-melanoma ayenzeka naseNyakatho Yurophu naseNyakatho Melika. I-melanoma ivela kancane kakhulu e-Asia, e-Afrika naseLatin America. E-United States, i-melanoma yenzeka izikhathi ezingaba ngu-1.6 kaningi emadodeni kunabesifazane.
○ Izimpawu nezimpawu
Izimpawu zokuqala ze-melanoma izinguquko ekubunjweni noma kumbala we-nevus ekhona. Endabeni ye-melanoma yama-nodular, ukubonakala kwesigaxa esisha esikhumbeni. Ezigabeni zakamuva ze-melanoma, i-nevi ingase ilume, ibe nesilonda, noma yophe.
[A-Asymmetry] I-asymmetry yomumo
[B-Borders] Umngcele (ongajwayelekile onemiphetho namakhona)
[C-Color] Umbala (ohlukile futhi ongajwayelekile)
[D-Diameter] Ububanzi (obukhulu kuno-6 mm = 0.24 amayintshi = obulingana nosayizi werabha lepensela)
[E-Evolving] Ziphenduke ngokuhamba kwesikhathi
cf) I-Seborrheic keratosis ingase ihlangabezane nenye noma yonke imibandela ye-ABCD, futhi ingaholela kuma-alamu angamanga.
I-Metastasis ye-melanoma yokuqala ingenzeka, kodwa ayivamile; ngaphansi kwengxenye yesihlanu ye-melanoma etholwe ngaphambi kwesikhathi iba yi-metastatic. Ama-metastases ebuchosheni avamile ezigulini ezine-melanoma ye-metastatic. I-Metastatic melanoma ingasakazekela esibindini, emathanjeni, esiswini, noma kuma-lymph node akude.
○ Ukuxilongwa
Ukubheka indawo okukhulunywa ngayo kuyindlela evame kakhulu yokusola i-melanoma. Ama-Nevus anombala ongajwayelekile noma umumo ngokuvamile aphathwa njengamakhandidethi e-melanoma.
Odokotela ngokuvamile bahlola wonke ama-moles, kuhlanganise nalawo angaphansi kuka-6 mm ububanzi. Uma isetshenziswa ochwepheshe abaqeqeshiwe, i-dermoscopy iyasiza kakhulu ekuboneni izilonda eziyingozi kunokusebenzisa iso lenyama lodwa. Ukuxilongwa kwenziwa nge-biopsy yanoma yisiphi isilonda sesikhumba esinezimpawu zokuthi singaba nomdlavuza.
○ Ukwelashwa
#Mohs surgery
Udokotela wakho angase atuse i-immunotherapy ikakhulukazi uma une-melanoma yesiteji sesi-3 noma sesi-4 esingakwazi ukususwa ngokuhlinzwa.
#Ipilimumab [Yervoy]
#Pembrolizumab [Keytruda]
#Nivolumab [Opdivo]