Cutaneous Melanoma Case Study

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Mohs microscopic surgery (MMS) is still perceived as a somewhat unfamiliar and unknown treatment option to many patients with melanoma. Wide local excision (WLE) has been the standard treatment option until the recent years, with emergence of multiple literatures that have shown successful treatment of melanoma cases, presenting with high cure rate and low recurrence rate. However, variations among many physicians and practices still exist due to a lack of strict criteria and guidelines in using MMS. These variations are problematic because they can lead to financial burden for patients and inconvenience of multiple surgeries that can be avoidable1. To be able to improve the quality of patient care, a strict criteria and guidelines must …show more content…

This process is expressed in about 60% of melanoma cases, aiding more frequently in proliferation of tumor cells, especially on non-sun exposed skin, such as trunk and legs. Numerous studies have shown that BRAF mutation is present in primary and metastatic melanoma5. This mutation in BRAF proceeds to the activation of RAF/MEK pathway, which is the communication of proteins that play a role in transporting signals from a receptor on the surface to the DNA in the nucleus of the cell. Epidemiology of Cutaneous Melanoma There are three main types of skin cancer: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. CM is the rarest kind, but is also in the most dangerous form, occurring 91.2% of all melanoma. The occurrence of CM has been increasing over the past few decades, affecting not just adults but also in children and adolescents, with average age in the seventh decade6. It is ethnicity-dependent, with highest chance in Caucasian population, but other groups can also be affected7. Men usually develop melanoma on the trunk, whereas women on the extremities, but more men are affected (46,870 men and 29,510 women), according to an estimation by The Skin Cancer Foundation in 20168. People who live in areas with more intense sun exposure can also have higher risk. Besides direct UV exposure, those who have personal or family history of skin cancer or any atypical nevi are also at higher risk.

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