| Abstract | Maligni melanom je zloćudni tumor koji nastaje iz melanocita, a zbog velike sklonosti ranom metastaziranju ubraja se u najzloćudnije tumore kože i sluznica. Incidencija melanoma u svijetu u stalnom je porastu. Najvažniji čimbenici u nastanku melanoma su izloženost UV zračenju, obiteljska predispozicija, tip i broj nevusa, tip kože i pigmentacija, te imunosupresija. Prevencija je ključan čimbenik u smanjenu rizika od obolijevanja bilo koje bolesti pa tako i melanoma. Važna je i edukacija o odgovornom ponašanju prema vlastitom zdravlju, te poticanje na redovito provođenje samopregleda pigmentnih nevusa. Što se populacija više osvijesti na uočavanje i prepoznavanje sumnjivih promjena na koži poboljšat će se i pravovremeno javljanje dermatologu. Rana dijagnoza i rani početak liječenja najvažniji su čimbenici dobre prognoze bolesti. Redovito pregledavanje (jednom mjesečno) neophodno je za rano prepoznavanje melanoma. Da bi se obavio pravilan samopregled potrebno je pregledati cijelo tijelo, od glave do stopala, sprijeda, straga i postranično, te ne zaboraviti na vlasište, uške i spolovilo. ABCDE metoda ukazuje na promjene koje je potrebno gledati kod samopregleda nevusa. To su promjena oblika prethodno pravilnog, simetričnog nevusa u asimetričan i nepravilan oblik (A-engl. asymmetry), neoštra ograničenost od okolne kože u prethodno oštro ograničenom nevusu (B-engl. border), pojačanje pigmentacije te pojava neravnomjerne pigmentacije u prethodno jednobojnom nevusu (C-engl.color), povećanje nevusa (D-engl. diameter), elevaciju- zadebljanje i uzdignuće nevusa (E-engl.elevation). Osim pet glavnih simptoma pri promjeni nevusa, važni su i znakovi upale, pojave erozija i krvarenja te subjektivan osjećaj svrbeža i bolova u nevusu. Sve pigmentne promjene u nevusu treba ozbiljno shvatiti i pažljivo ih promatrati.
U dijagnostici važnu ulogu ima obiteljska i osobna anamneza, detaljan klinički pregled, patohistološka dijagnoza, te dermatoskopija. |
| Abstract (english) | Malignant melanoma is a malignant tumor that develops from melanocytes. Because of its strong tendency for early metastasis, it is considered one of the most malignant skin and mucous membrane tumors. Worldwide melanoma incidence has been steadily rising over the years. The most important factors in the development of melanoma are ultraviolet light (UV) exposure, familial predisposition, the number and type of nevi, skin type and pigmentation, and immunosuppression. Just like with any other disease, prevention is the key factor in the reduction of risk of melanoma development. Education on responsible consideration of personal health and regular self-examination of pigmented nevi are also of great importance. Early diagnosis and treatment are the most important factors of a beneficial prognosis. Regular (monthly) skin self - examinations are essential for an early detection of a melanoma. To conduct proper self-examination it is necessary to visually inspect the whole body, from head to toe, frontally, laterally and posteriorlly, not forgetting the scalp, earlobes and sex organs. The “ABCDE” method indicates signs and symptoms of changes that should be considered when performing the self-examination of nevi. These are: changes from a previously regular and symmetrical shape of a nevus into an irregular and asymmetrical shape (A – asymmetry); irregular delineation of the surrounding skin on the previously clearly delineated nevus (B – border); changes in pigmentation or irregular coloring of a previously monochromatic nevus (C – color), changes in size of a nevus (D – diameter); elevation - enlarged, evolved or elevated nevus (E – elevation). Apart from these five main symptoms of nevus change, it is also important to note any inflammation, erosion or bleeding of the nevus, as well as any subjective sensations of itching and pain of the nevus. Any changes in pigmentation or coloring of the nevus should be taken seriously and closely monitored.
Family and personal medical history, detailed clinical examinations, histopathological diagnosis and dermoscopy are all essential for diagnostics. |
