Superficial Spreading Melanoma is the most common subtype accounting for 70 to 80% of all melanomas.
It is most common in middle-aged from the fourth to fifth decade.
Melanoma is arising in a pre-existing lesion most are superficial spreading.
Superficial Spreading Melanoma is slightly more common in females than males and usually affects Caucasians.
Any cutaneous sight may be involved but they are most often found on the upper back of both sexes and on the legs of women.
Lesions tend to be greater than six millimeters in diameter flat and asymmetric with varying colors.
Superficial spreading melanoma begins in a nonspecific manner and then changes shape by radial spread and regression.
Lesions tend to spread laterally within the skin over a few years before nodules development.
The random migration of cells along with the process of regression results in lesions with an endless variety of shapes and sizes.
The shape is bizarre if left untreated for years.
The hallmark of superficial spreading melanoma is the haphazard combination of many colors but it may be uniformly brown or black.
Colors may become more diverse as time proceeds.
A dull red color is frequently observed and may occupy a small area or may dominate the lesion.
The precursor radial growth phase may last four months or four years.
This is a low-powered derma scopic view of an entire lesion Our initial impression of this lesion that is is that it’s highly disorganized and probably a superficial spreading melanoma.
But we’re going to examine all of the components and use the seven-point checklist
Let’s look at the pigment Network in this small area here it appears typical the lines are uniform the circles are uniform
We come to this part of the lesion see that the lines are dense
It is organized they don’t form a net-like or reticular pattern of this very wide area there’s
A very definite and prominent bluish white Vale here and in this area
These areas are translucent they have a light faint blue color in the background indicating melanin pigmentation in the upper and lower dermis
These are highly characteristic features of superficial spreading melanoma
This area in contrast looks like an area of regression
It’s smoother and a brighter white
There’s an atypical vascular pattern here here and here small red dots
When you examine the periphery of the lesion I don’t see any finger-like projections so there really no irregular streaks
The pigmentation is irregular dark here lighter here even lighter in this area highly disorganized
There are a few dots but no larger dots that I would describe as globules and then it is regression structure that we mentioned before
So this lesion has an atypical pigment Network, a bluish-white veil, and a typical vascular pattern,
We don’t see any irregular streaks the pigmentation is irregular
There are a few irregular dots and globules and there are regression structures so there’s little doubt the diagnosis this is a superficial spreading Melanoma
Now let’s look at a high-powered view the bluish white veil is prominent
Now you get a better feeling for the blue tinge in the background indicative of melanin pigmentation deeper than the epidermis
Here are the atypical vascular structures
They’re not prominent and they’re often difficult to see even with the derma scope
The pigment network is highly disorganized
There’s no regular net-like pattern
The lines are thick in they’re joined in an unusual manner
This is the corner of that regression structure
Its smoother a little brighter but in many instances is difficult to distinguish.