A new or changing mole or blemish is the most common warning sign for melanoma. Variation in color and/or an increase in the size or asymmetry of a mole are concerning for melanoma. Symptoms such as bleeding, itching, ulceration, and pain in a mole should also be evaluated. The majority of melanomas arise as new moles in areas where there was no mole before.
The ABCDE criteria for screening a mole for melanoma are as follows:
Any mole that is suspicious for a melanoma should always be biopsied with a punch biopsy and never a shave biopsy. This is because a shave biopsy will not allow the pathologist to determine the true thickness and depth of the melanoma, which is crucial information which guides further treatment.
Hearing that you have a diagnosis of melanoma can be worrisome. You want to make sure that you are cared for in a coordinated manner with your dermatologist and plastic surgeon, so that everyone involved knows the plan of treatment. If the melanoma is deep or has certain characteristics on the biopsy, you will need a sentinel lymph node biopsy performed when the melanoma is removed.
During surgery, the melanoma will be removed with a margin of normal tissue. The defect can be closed and reconstructed with a variety of techniques including simple closure, skin grafting, small flaps, and tissue expansion. The reconstruction will depend on the size of the defect and the area on your body. A sentinel lymph node biopsy is performed to sample the lymph nodes that the melanoma could have spread to. If melanoma is found in the lymph nodes, you will need to see an oncologist who will discuss further treatment options. There are new, exciting, and promising new melanoma chemotherapy treatments that have been recently approved by the FDA and you will hear about all your options.
Dr. Shareef Jandali is one of the co-founders of the Melanoma Center at Bridgeport Hospital, part of Yale New Haven Health System. The Melanoma Center is a multidisciplinary team of physicians including surgeons, dermatologists, pathologists, medical oncologists, and radiation oncologists. The goal of the center is to provide cutting edge melanoma treatment to patients in Fairfield County, Connecticut and surrounding areas.
If you have been diagnosed with melanoma and need surgical treatment, come visit our plastic surgery office in Fairfield County, Connecticut. Call 203-374-0310 to set up an appointment with Board Certified plastic surgeon Dr. Shareef Jandali. We look forward to seeing you!