Dhealthwellness.com – Melanomas are dark, raised lesions that can develop anywhere on your body. They usually start in the cells (melanocytes) that produce the pigment melanin, which gives your skin, hair, and eyes their color.
Types of Precancerous Skin Lesions that Often Start in Older People
Look for moles that are different in size, shape, or color from your other moles. Also, keep an eye out for new spots or areas of redness that may be suspicious. Lentigo maligna (LM) is a type of precancerous skin lesion that often starts in older people with fair skin and sun damage. It can develop into melanoma if it grows and spreads to other parts of the body.
Like other types of melanoma, lentigo malignant melanoma is often diagnosed and treated before it becomes invasive. In fact, it’s one of the few forms of melanoma that’s more likely to survive when caught early. This type of cancer can appear as a flat or slightly raised brown patch on the skin, similar to freckles or an age spot. It’s usually a shade of brown or pink, though it can also be red or white.
Dermoscopy (using a dermatoscope) is sometimes used to make the diagnosis of LM or LMM. It can help doctors distinguish lentigo maligna from other types of pigmented lesions, such as those that form around facial hair follicles. It can also reveal a network of lines, an atypical rhomboid pattern and greyish dots (Figure 2). Leukemia-like spots occur when blood cancer cells break out of the bone marrow and infiltrate the skin, according to MedlinePlus. These lesions may look like bruises or red spots that are scattered across the skin.
Leukemia-Like Spots Often Occur
Leukemia-like spots are common in people with leukemia and can also appear as a result of certain treatments, including chemotherapy. Bruises on the arms, legs or hands are another common symptom of leukemia, which can affect how well the body can repair itself. These small, flat, and painless red spots are called petechiae, which are caused by the breakdown of tiny blood vessels near the skin’s surface. They may appear in people with leukemia and other conditions, such as thrombocytopenia or infection.
In 7% of cases of leukemia, the first symptom is a skin lesion. This is known as leukemia cutis and can lead to enlarged lymph nodes, spleen, and liver. Treatment usually involves systemic chemotherapy, which is the most effective way to treat underlying leukemia. Melanoma is a type of skin cancer that arises from cells in your skin called melanocytes. These cells are responsible for your skin’s color (melanin).
Acral lentiginous melanoma is a less common type of melanoma, making up only about 5% of all melanomas diagnosed each year. It’s most common in people with darker skin, including African Americans and those of Asian descent. This form of melanoma usually starts as a spot that is much darker than the rest of your skin. This is a sign that the melanocytes in your skin are growing faster than normal, leading to melanoma.
Acral Lentiginous Melanoma Usually Grows in One Location
Unlike other types of melanoma, acral lentiginous melanoma usually grows in one location, typically on the palms and soles. However, it can also appear under the nail beds, sometimes called subungual melanoma. When it occurs on the nail, it can appear as an irregularly pigmented band or streak of color that runs from the cuticle to the tip of the fingernail or toenail. Melanoma of the nail unit is an uncommon form of melanoma that is associated with a poor prognosis. It is often diagnosed later than other types of melanoma and may have spread at the time of diagnosis.
The most common clinical appearance is a brown-black discoloration of the nail bed (or nail plate). The lesion can be irregular and can also appear as a streak of color. The discoloration can progress to thickening, splitting, or destruction of the nail with pain and inflammation. A periungual pigmentation (Hutchinson sign) may also be present, which supports the clinical diagnosis of melanoma. The presence of the Hutchinson sign should prompt a referral to a specialist dermatologist.
To make the definitive diagnosis, a biopsy of the nail matrix and the nail bed is performed. A pathologist specializing in identifying cancerous cells will then examine the tissue to determine whether it is melanoma. The doctor will stage the melanoma based on how many cancerous cells are found and how they have spread.
Mogensen, M., Joergensen, T. M., Nürnberg, B. M., Morsy, H. A., Thomsen, J. B., Thrane, L., & Jemec, G. B. (2009). Assessment of optical coherence tomography imaging in the diagnosis of non‐melanoma skin cancer and benign lesions versus normal skin: observer‐blinded evaluation by dermatologists and pathologists. Dermatologic Surgery, 35(6), 965-972.
McLaughlin-Drubin, Margaret E. “Human papillomaviruses and non-melanoma skin cancer.” Seminars in oncology. Vol. 42. No. 2. WB Saunders, 2015.