Excisional Skin Biopsy for Melanoma

Melanoma is a malignant tumor of melanocytes whichexcessive scarring and morbidity from the procedure.
are found predominantly in skin but also in the bowelLactate dehydrogenase (LDH) tests are often used
and the eye. It is one of the less common types ofto screen for metastases, although many patients
skin cancer but causes the majority of skin cancerwith metastases have a normal LDH; extraordinarily
related deaths. Melanocytes are normally present inhigh LDH often indicates metastatic spread of the
skin, being responsible for the production of the darkdisease to the liver. It is common for patients
pigment melanin.diagnosed with melanoma to have chest X-rays and
Around 60,000 new cases of invasive melanoma arean LDH test, and in some cases CT, MRI, PET or
diagnosed in the US each year, more frequently inPET/CT scans.
males and in Caucasians. It is more common inAlthough controversial, sentinel lymph node biopsies
Caucasian populations living in sunny climates than inand examination of the lymph nodes are also
other groups, or in those who use tanning salons.performed in patients to assess spread to the lymph
According to a WHO report about 48,000 melanomanodes. Sometimes the skin lesion may bleed, itch, or
related deaths occur worldwide per year.ulcerate, although this is a very late sign. A
Excisional skin biopsy is the management of choiceslow-healing lesion should be watched closely, as that
for melanoma diagnosis; this is where the suspectmay be a sign of melanoma. Some patients with
lesion is totally removed with an adequate ellipse ofmetastatic melanoma do not have an obvious
surrounding skin and tissue. The preferred surgicaldetectable primary tumor.
margin for the initial biopsy should be narrow in orderBe aware also that in circumstances that are still
to prevent the disruption of the local lymphaticpoorly understood, melanomas may "regress" or
drainage.spontaneously become smaller or invisible; however
The biopsy will include the epidermal, dermal, andthe malignancy is still present. Amelanotic melanomas
subcutaneous layers of the skin, enabling thedo not have pigment and may not even be visible.
histopathologist to determine the thickness of theLentigo maligna, a superficial melanoma confined to
melanoma by microscopic examination. This isthe topmost layers of the skin is often described as
described by Breslow's thickness. Large initial excisiona "stain" on the skin.
will disrupt the local lymphatic drainage and can affectThe treatment includes surgical removal of the
further lymphangiogram directed lymphnodetumor, adjuvant treatment, chemotherapy,
dissection.immunotherapy, or radiation therapy. NeviCurative
A small punch biopsy can be utilized at any timeprovides a safe and effective alternative to current
where for logistical and personal reasons a patientmedical treatments that can be invasive and
refuses more invasive excisional biopsy. Small punchexpensive. It provides total clearance of moles
biopsies are minimally invasive and heal quickly, usuallywithout any recurrence, discomfort, or tissue
without noticeable scarring. Thus, a small punchdamage.
biopsy in representative areas will give adequateThe therapeutic action of NeviCurative is
information and will not disrupt the final staging oraccomplished via its rapid absorption into the skin
depth determination.where moles occur. The certified organic antimicrobial
For large lesions such as suspected lentigo maligna, orplant extracts in NeviCurative are lipophilic (easily
for lesions in surgically difficult areas (face, toes,absorbed into fatty tissue such as the skin) and have
fingers, eyelids), a small punch biopsy ina low molecular weight. This allows them to pass
representative areas would be enough. In noreadily through skin tissue and into cell membranes
circumstances should the initial biopsy include the finalwhere they eradicate nevi.
surgical margin, as a misdiagnosis can result in