Melanoma is the most dangerous type of skin cancer. It is a malignant tumor that forms in melanocytes (cells that produce the pigment that gives color to the skin). About 95% of melanomas develop in the skin and only rarely in mucous membranes, internal organs, or other locations.

Although the risk of developing skin cancer increases with age, melanoma is also one of the most common cancers in young adults (especially women).

Over the past 30 years, its incidence has increased exponentially. More than 150,000 new cases are diagnosed worldwide each year.

Prevention and early detection are extremely important, as advanced melanoma can become life-threatening.

CausasCausasCauses

Causes

The exact causes of melanoma are not completely understood, but it is most likely due to a combination of factors, with ultraviolet (UV) radiation exposure being the most significant.

Other associated risk factors include:

  • Number of moles: Having more than 50 moles on the body increases the likelihood of developing melanoma compared to someone with few or no moles. Unusual (dysplastic) moles are more dangerous, often having irregular borders, larger size, and mixed colors.
  • Age: Melanoma can appear at any age. Although it is increasingly diagnosed in young adults, most cases occur before age 55. After age 70, nodular or acral melanomas are more common.
  • Sex: It is slightly more frequent in women and often appears on the upper and lower limbs due to sun exposure. In general, melanoma in women tends to have a better prognosis than in men.
  • Race: Melanoma is more common in individuals with fair skin, as lower levels of melanin provide less natural protection from the sun. In Black individuals, melanoma more commonly appears on the palms of the hands, soles of the feet, and mucous membranes—areas with less pigmentation.
  • Family history: Having a family member with melanoma increases the risk of developing it. While this may be due to genetic mutations, it is also likely related to shared lifestyle factors.
  • Weakened immune system: This includes individuals with AIDS or those taking immunosuppressive medications after organ transplants.
SíntomasSíntomasSymptoms

Symptoms

Melanoma can appear anywhere on the skin. It rarely develops in internal organs or the eyes.

It often develops from a pre-existing mole that begins to change. Warning signs include:

  • Size: Moles larger than 6 millimeters.
  • Irregular shape: Normal moles are usually round or symmetrical.
  • Irregular borders: Uneven or poorly defined edges may indicate melanoma.
  • Color changes: Moles that change color or contain multiple colors.
  • Itching or bleeding: Previously unnoticed moles that begin to itch, hurt, or bleed.
DiagnósticoDiagnósticoDiagnosis

Diagnosis

The only reliable way to diagnose melanoma is through a biopsy of the suspicious lesion (skin, mucosa, etc.). A pathologist determines whether the sample is melanoma.

Self-Examination

People at risk should regularly examine their moles. If any significant changes are noticed, they should consult a dermatologist.

Using mirrors can help ensure a thorough examination of the entire body, including arms, legs, groin, and even under the nails.

TratamientosTratamientosTreatment

Treatment

Treatment depends on the stage of the melanoma.

Early stages (confined to the skin):
The melanoma is completely removed with a small margin of healthy skin. A pathologist examines the margins to ensure complete excision. A sentinel lymph node biopsy is often recommended.

Advanced stages (spread beyond the skin):
A multidisciplinary medical team determines the appropriate treatment plan, which may include:

  • Sentinel lymph node removal: If there is suspicion of spread, the corresponding lymph node is removed.
  • Targeted drug therapy: Medications such as trametinib, dabrafenib, or vemurafenib, depending on the melanoma type. Many have significant side effects.
  • Immunotherapy: Agents such as ipilimumab, interferon, or interleukin-2. Side effects often resemble flu-like symptoms.
  • Chemotherapy: Usually administered intravenously, though sometimes orally.
  • Radiotherapy: Directed at the primary melanoma and/or affected lymph nodes.

Prevention

Prevention is key. The following measures can reduce the risk of skin cancer:

  • Avoid sun exposure during peak hours (midday).
  • Use sunscreen year-round.
  • Wear sunglasses.
  • Avoid tanning beds.
  • If you have many moles, have them checked annually by a dermatologist. A dermatoscope may be used to create digital mole mapping, allowing comparison over time to detect suspicious changes.
Specialties:
  • Dermatology