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Harrison's Principles of Internal Medicine, 18e
| Part 7. Oncology and Hematology > Section 1. Neoplastic Disorders > |
Chapter 87. Cancer of the Skin
Sections: Melanoma, Nonmelanoma Skin Cancer, Acknowledgment, Further Readings.
Topics Discussed: dermatologic drug reactions and self-treatable skin disorders; pathophysiology of diseases of the skin; pathophysiology of neoplasia; skin cancer; skin carcinoma.
Excerpt:"Pigmented lesions are among the most common findings on skin examination. The challenge is to distinguish cutaneous melanomas, which account for the overwhelming majority of deaths resulting from skin cancer, from the remainder, which with rare exceptions are benign. Cutaneous melanoma can occur in adults of all ages, even young individuals, and people of all colors; it is located on the skin, where it is visible; and it has distinct clinical features that make it detectable at a time when complete surgical excision is possible. Examples of malignant and benign pigmented lesions are shown in Fig. 87-1.Melanoma is an aggressive malignancy of melanocytes: pigment-producing cells that originate from the neural crest and migrate to the skin, meninges, mucous membranes, upper esophagus, and eyes. Melanocytes in each of these locations have the potential for malignant transformation. In the United States, nearly 69,000 individuals were expected to develop melanoma and approximately 9,000 were expected to die in 2010. Although the overall incidence and mortality have increased over the last decades, the mortality rates for younger patients have flattened whereas those rates for individuals over age 65 have continued to increase. It is predominantly a malignancy of white-skinned..."
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