95% of melanomas are pigmented to varying degrees. Everyone seems to fear
the black mole. What about the other 5%? These are often amelanotic
melanomas (those without color).
Clinically, these are among the
toughest to diagnose, but also of the utmost importance.
Because they are often so unimpressive to look at, they are presumed
to be of little consequence, whereas in fact, they are every bit as dangerous
(if not more so) than pigmented melanomas. If neglected, the
patient pays an awful price. For a clinical perspective, review the
photographs and see why the diagnosis is often missed. Don't let it
happen to you!
Multiple melanomas are seen in 8-12% of patients
who develop melanoma. The photograph at left is of a young woman with
two melanomas on her right breast at the same time. One is pigmented
and the other is amelanotic. Another recent patient developed six
melanomas over a period of three years. We have seen
ten patients in the last five years develop another melanoma or
more following their first melanoma. Any patient who has had a
melanoma should be re-evaluated every three months for new lesions.
We can recognize them a lot faster than the patient. Waiting works to
the disadvantage of the patient.
It is also worth mentioning
that patients with a history of breast cancer are at greater risk of
developing melanoma. It would be a good idea for any cancer patient,
any transplant patient or those patients on chemotherapy or
immunosuppressive therapy to be evaluated by a dermatologist at six
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More pictures of amelanotic melanomas: