Melanoma Quiz, featured in the University of Wisconsin Carbone Cancer Center's "Advances" Newsletter
2.) Melanomas always have a dark discoloration.
3.) Sunscreen with an SPF of 30 is twice as strong as one with SPF 15.
4.) If a melanoma has spread to lymph nodes, the lung is the internal organ that has the higher risk of getting involved next.
5.) There are identified risk factors for developing melanoma.
6.) Melanomas are only found on skin surfaces that are exposed to the sun.
7.) Early diagnosis is important for a melanoma patient.
8.) A shave biopsy is the best approach for a skin lesion suspected of being a melanoma.
9.) Melanoma is usually curable once spread to distant sites.
10.) Clinical features of a skin lesion can help identify melanomas.
ANSWERS:
1.) False. More than half of melanomas develop de novo, which means that they develop on the normal skin without a mole.
2.) False. A small subset of melanomas does not have brown or dark pigmentation. They are called amelanotic melanoma.
3.) False. SPF 30 blocks about 96.7% sun rays, while SPF 15 blocks 93.3%. By doing the same math, SPF 50 blocks 98% and SPF 100 blocks 99%. Therefore, one gets marginal benefit after the SPF number is higher than 30.
4.) True.
5.) True. Risk factors for melanoma include a positive personal or family history of melanoma, multiple atypical or dysplastic nevi, light complexion, history of blistering sunburns, and use of tanning beds.
6.) False. Melanoma can be found on any skin surface, including areas with little or no history of sun exposure, mucous membranes, in the eyes, or as metastatic disease without a clear primary site.
7.) True. Early diagnosis is critical to patient outcome. Even melanomas with one millimeter of thickness at the time of diagnosis carry a risk of recurrence and death. Therefore, the clinician should have a low threshold for the evaluation and removal of changing legions.
8.) False. Ideally, a suspect lesion should be removed by excisional biopsy, including elliptical or punch biopsy. The full thickness of the questioned lesion needs to be included in this initial biopsy.
9.) False. New insights are critically needed to achieve durable benefit for patients with metastatic melanoma, as the cancer is usually incurable once metastatic to distant sites.
10.) True. Clinical features that help guide early identification include the "A, B, C, D and E's":
"A" asymmetry
"B" irregular or notched borders
"C" irregular distribution of color"D" diameter of 6mm or greater
"E" new elevation, erosion or ulceration
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