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Risk elements embody the fol lowing: • Fair complexion, blue eyes, purple or blond hair, and freckles • Celtic or Scandinavian origin • Tendency to burn and not tan; signi?cant historical past of severe sunburn • Older age; residence within the southwestern United States • Family or personal history of melanoma, the absence of a gene on chromosome 9P, presence of giant congenital nevi • Dysplastic nevus syndrome Clinical Manifestations Super?cial Spreading Melanoma • Most widespread type; usually affects middle-aged people, happens most regularly on trunk and decrease extremities • Circular lesions with irregular outer parts • Margins of lesion ?at or elevated and palpable • May seem together of colors, with hues of tan, brown, and black combined with grey, bluish black, or white; typically a uninteresting, pink-rose color is noted in a small area throughout the lesion Lentigo-Maligna Melanoma • Slowly evolving pigmented lesion • Occurs on uncovered pores and skin areas; hand, head, and neck in eld erly people • First seems as tan, ?at lesion, which in time undergoes changes in dimension and color Nodular Melanoma • Spherical, blueberrylike nodule with comparatively clean sur face and uniform blue-black shade Cancer of the Skin (Malignant Melanoma) 193 • May be dome-shaped with a clean floor or have other shadings of red, gray, or purple • May appear as irregularly formed plaques C • May be described as a blood blister that fails to resolve • Invades instantly into adjoining dermis (vertical development); poor prognosis Acral-Lentiginous Melanoma • Occurs in areas not excessively exposed to daylight and the place hair follicles are absent • Found on the palms of the palms, soles, in nail beds, and mucous membranes in dark-skinned individuals • Appears as an irregular pigmented macule that develops nodules • Becomes invasive early Assessment and Diagnostic Methods • Excisional biopsy specimen; incisional biopsy when the sus picious lesion is just too giant to be removed safely without in depth scarring. 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