What Is a Nevoid Melanoma of Skin?
Nevoid melanoma is a rare, distinctive subtype of skin cancer. It develops when the melanocytes in the skin grow uncontrollably and form tumors. Melanocytes are the skin cells that produce melanin, the dark pigment that determines skin color. This type of melanoma is commonly seen in young and middle-aged adults. Nevoid melanoma may originate from a preexisting mole or normal healthy skin. Most nevoid melanomas are found in arms or legs, but they can occur anywhere on the body. Nevoid melanomas are small-sized, often well-defined, solitary lesions. Tumors on the face and neck can present cosmetic problems.
What Are the Different Variants of Nevoid Melanoma?
A few variants of nevoid melanoma include:
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Small cell melanoma.
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Spitzoid melanoma.
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Minimal deviation melanoma.
Who Gets Nevoid Melanoma?
The condition is generally seen in young and middle-aged adults, with a peak age range of 40 to 50. Both males and females are affected with nevoid melanoma, though a slight preference for females is reported. Nevoid melanoma, a rare subtype, accounts for less than one percent of all melanomas. Nevoid melanomas occur more commonly in Caucasians as compared to other races. A few factors may raise the risk for nevoid melanoma of the skin, such as:
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Prolonged exposure to ultraviolet (UV) radiation from the sun and tanning lights and beds is one of the significant risk factors for all melanomas, including nevoid melanoma.
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Nevus (mole) is a benign (non-cancerous) pigmented tumor. Having more than multiple ordinary in the body indicates an increased risk of melanoma. Also, having an unusual mole (dysplastic nevi) increases the risk of melanoma.
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Fair-skinned people are more likely to get melanomas, especially those with freckles or who quickly develop sunburns, than those with a darker complexion. Individuals with blond or red hair color and those with blue eyes also have a higher risk of developing melanomas.
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Those with a previous history of melanoma or a history of melanoma in parents or siblings also have more chance of developing melanoma.
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People having weakened immune systems are more vulnerable to nevoid melanoma and other skin cancers. The immune system may get impaired due to specific immunosuppressants or medical conditions such as acquired immunodeficiency syndrome (AIDS) or after an organ transplant.
It is important to remember that having a risk factor does not mean that one will get this condition. Instead, a risk factor increases a person's likelihood of getting a condition compared to one without the risk factors. However, not having a risk factor does not indicate one will not get the condition. Therefore, discussing the effect of risk factors with a healthcare provider is always important.
What Causes Nevoid Melanoma of Skin?
Due to various factors, nevoid melanoma can occur from specific cells, called melanocytes, from the skin that has been damaged or from normal healthy skin. Experts believe it can also arise from the skin component of a benign lentigo (liver spots) or a benign nevus (mole). Sometimes, nodular melanoma may be the precursor to nevoid melanoma.
What Are the Symptoms of Nevoid Melanoma?
Nevoid melanoma may appear in a previously benign mole. The signs and symptoms may include:
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Solitary, soft, and firm skin lesions; inflammation is not usually noted.
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Slow-growing, regular-to-irregularly shaped, small nodules or papules.
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The lesions can be brown or black.
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The lesions can be warty-like.
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The tumor boundaries may be clearly defined.
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Tumor sizes can range between 0.5 to one centimeter; some may be over one centimeters.
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The most commonly affected areas include the legs, the arms, and the legs. Other affected areas can be the head and neck region and the body or trunk.
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Some skin lesions may not have signs and symptoms during the early stages.
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Ulceration and bleeding lesions are uncommon.
How Is Nevoid Melanoma of the Skin Diagnosed?
Diagnostic tests and procedures used to diagnose nevoid melanoma include:
A detailed history and a complete physical examination by a health care provider are essential for diagnosing nevoid melanoma of the skin. Other tests include:
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Biopsy - A skin sample from any suspected area found on physical examination is taken and sent to a laboratory for further examination. The type of biopsy procedure the healthcare provider recommends depends on the situation. Most often, providers suggest removing the entire growth when possible.
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Imaging - If the melanoma is suspected of having metastasized (spread) to internal organs, imaging tests, like X-ray, magnetic resonance imaging (MRI), or computed tomography (CT) scan of the affected areas may be carried out.
Further tests should be done to make a differential diagnosis to rule out the following conditions:
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Spitz nevus.
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Proliferative nodules in a congenital nevus.
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Deep penetrating nevus.
What Are the Potential Complications of Nevoid Melanoma on the Skin?
The complications may include the following:
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Spread of the tumor to local and distant areas.
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Side effects from various treatment therapies.
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Recurrence due to incomplete surgical excision.
How Is Nevoid Melanoma of the Skin Treated?
The treatment choice for nevoid melanoma depends on the size and stage of cancer, the individual's overall health, and personal preferences. Treatment options for melanoma include:
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Melanoma Surgery: Surgery is usually the preferred option to treat early-stage melanoma (melanoma that has not spread to other areas of the body). However, it can also be done to cure more advanced-stage melanomas.
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Chemotherapy: In chemotherapy, drugs kill the cancer cells, leaving healthy cells untouched. Chemotherapy may be given as oral pills or injected into veins. However, this therapy may have side effects, such as nausea, vomiting, loss of appetite, mouth sores, hair loss, diarrhea, fatigue, increased risk of infection, or easy bruising, depending on the drug used.
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Immunotherapy: This drug treatment stimulates the immune system and involves using substances created naturally by the body or similar synthetics made in a laboratory. Drugs used in chemotherapy include synthetic immune proteins and proteins that stimulate the immune system (cytokines- interferon-alpha or interleukin-2). Synthetic immune proteins can cause the immune system to attack other body parts, while cytokine side effects may include fatigue, chills, fever, headaches, and muscle aches.
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Targeted Cancer Therapy: These drug treatments focus on specific weaknesses present within cancer cells. Targeting these weaknesses can cause cancer cells to die. For example, cells from melanoma may be tested to see if targeted therapy is effective against melanoma. For melanoma, targeted therapy might be suggested if cancer has spread to the lymph nodes or other sites. Side effects of targeted cancer therapy may include fatigue, nausea, rash, joint pain, itching, hair loss, sensitivity to the sun, and heart rhythm problems.
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Radiation Therapy: It includes treatments with high-energy rays like X-rays and protons to kill cancer cells and shrink tumors. The therapy may be directed to the lymph nodes if the melanoma has spread. It can also treat melanomas that cannot be entirely removed with surgery. For melanoma that spreads to other sites of the body, radiation therapy can help reduce symptoms.
How Can Nevoid Melanoma Be Prevented?
A few steps can help prevent nevoid melanoma, including:
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Avoid direct exposure to ultraviolet (UV) radiation and stay in the shade, especially between 10 a.m. and 4 p.m.
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When going outdoors, apply a generous amount of sunscreens with a sun protection factor (SPF) value higher than 30. Then, reapply every two hours and also after extreme sweating.
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Wear sunglasses, hats with brims, long-sleeved shirts, and pants whenever possible while heading out in the sun.
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Avoid tanning beds and sun lamps.
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Use a lip balm with sunscreen.
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The American Cancer Society suggests eating a plant-based diet over an animal-based diet to avoid all cancers.
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Get a professional skin examination done by a healthcare provider once a year.
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Self-examine the skin, from head to toe, once a month.
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Early detection is essential to minimize the risks associated with nevoid melanomas. Tell a healthcare provider about new or changing moles, sores, or skin discolorations.
What Is the Outlook of Nevoid Melanoma of the Skin?
The prognosis of nevoid melanoma is similar to other conventional forms of skin melanoma. Most nevoid melanomas can be cured if treated before spreading to other sites. However, more advanced cases can be life-threatening. Therefore, the earlier melanoma is detected and removed, the better the chances for recovery.
Conclusion:
Nevoid melanoma is an uncommon melanoma that develops in the skin's melanocyte cells. While it is a severe skin cancer, it is highly curable if detected early. Therefore, prevention and early treatment are essential, especially for people with certain risk factors. Self-examine the skin and tell the healthcare provider about new or changing moles, sores, or skin discolorations.
