Malignant melanoma is a malignant skin tumor that originates from melanocytes, the cells that produce the pigment melanin. It is among the most aggressive skin tumors, with a high tendency for early metastasis. Malignant melanoma can appear not only on the skin but also on mucous membranes, the eye, and the central nervous system. Unlike other forms of skin cancer, melanoma is an aggressive tumor with an extremely poor prognosis, which spreads easily and quickly to distant parts of the body, continuing to grow and destroy tissues.
For this reason, any skin change that shows alterations in color, shape, edges, or size should be taken seriously and examined by a dermatologist in a timely manner. Based on the clinical image and dermatoscopy, the dermatologist will decide whether surgical removal with microscopic analysis is necessary.
According to the World Health Organization, approximately 130,000 cases of malignant melanoma are diagnosed annually worldwide, with 41,000 deaths each year. In Croatia, around 500 new cases of melanoma are registered annually. In the past 30 years, the number of people diagnosed with malignant melanoma in Europe has doubled, and the mortality rate in Croatia is 50% higher than the average mortality rate in European Union countries, primarily because melanoma is often diagnosed at an advanced stage.
There are various risk factors for developing melanoma, with ultraviolet radiation being the most important, along with genetics, skin phototype, and the type and number of moles. Frequent sun exposure and sunburns in early childhood are significant risks for developing melanoma later in life. Even one or two instances of sunburn during childhood can double the risk of melanoma in later years. People who have had multiple sunburns throughout their life or those who occasionally spend intense time in the sun or expose themselves to artificial UV sources, such as tanning beds (which are banned in many countries for individuals under 18 due to their proven carcinogenic effects), are at particular risk.
In mole monitoring, the key aspect is skin examination and regular preventive dermatological mole checks with dermatoscopy. Dermatoscopy is a painless diagnostic examination that is a mandatory part of mole examination. It acts as a bridge between standard clinical mole examination and histopathological interpretation of moles that have been surgically removed. Dermatoscopy allows us to analyze the pigment and structure of pigmented changes through the skin layers, which is impossible to do with the naked eye. The value of dermatoscopy lies in the earlier detection of changes that indicate certain atypia (deviation from normal). During self-examination, it is important to monitor changes in the appearance of moles using the ABCDE rule (A – asymmetry, B – border, C – color, D – diameter, E – elevation, evolution, growth).
The importance of preventive mole examination programs is crucial because if melanoma is detected in its earliest stage (melanoma in situ), we can say that the cure rate is 100%. In this case, the melanoma is still limited to the superficial skin layer, the epidermis. The thicker the melanoma, the worse the prognosis and the higher the risk of metastasis. That is why regular preventive skin checks are highly recommended, as they can often save the lives of individuals who are at greater risk for developing melanoma.
