Invasive growth of the dermis

Introduction Superficial diffuse in situ melanoma: also known as Paget-like in situ black. In the case of invasive growth, the rate is much faster than malignant freckle-like sputum, often infiltration, nodules, ulcers or hemorrhage in 1 to 2 years, that is, development of dermal invasive growth, poor prognosis.

Cause

Clark (1969) studied the relationship between the depth of invasion of melanoma and prognosis, and classified the melanoma into 5 grades according to the depth of invasion. The higher the grade, the worse the prognosis.

Grade I: Tumor cells are restricted to the epidermis above the basement membrane.

Grade II: Tumor cells break through the basement membrane and invade the dermal papilla.

Grade III: The tumor cells are filled with the dermal papilla layer and further invade downward, but not to the dermal reticular layer.

Grade IV: Tumor cells have invaded the dermal reticular layer.

Grade V: The tumor cells have passed through the dermal reticular layer and invaded the subcutaneous fat layer.

an examination

Related inspection

Skin cancer detection physical examination of skin diseases

More common in middle-aged people, can occur in any part of the skin, but more common in non-exposed areas, and especially in the upper back and lower legs. The damage is less than that of malignant freckles, and the diameter is rarely more than 2.5 cm. It is often misdiagnosed as sputum cell sputum. Often light or obvious bulge, irregular shape, often curved or jagged on the edges, some of which are curved, characterized by varying inconsistencies and inconsistencies, yellow-brown, brown, reddish or even blue or black At the same time, it is mixed with grayish white. In the case of invasive growth, the rate is much faster than malignant freckle-like sputum, often infiltration, nodules, ulcers or hemorrhage in 1 to 2 years, that is, development of dermal invasive growth, poor prognosis.

Differential diagnosis

Differential diagnosis of dermal invasive growth:

(1) lentigo maligna: also known as Hutchinson freckles, rare, often occurs in older people, 60 to 80 years old male. Almost all of them are found in exposed areas, especially on the face, and very few can occur in non-exposed areas, which can be located on the forearm or calf. The disease begins as a spot with uneven pigmentation, generally does not bulge, the edges are irregular, and gradually expands to the periphery, the diameter can reach several centimeters, often one side expands, and the other side self-resolves. The lesions are light brown, brown, with irregular edges, which may be accompanied by dark brown to black small spots, while hypopigmentation is seen in the self-resolving zone.

The damage grows slowly, often over several years or decades, and about one-third of the lesions develop into invasive malignant melanoma. According to statistics, generally malignant freckles exist for 10 to 15 years, and the area is 4 to 6 cm. Invasive growth occurred later, and the original lesions were indurated, marking the invasion of the dermis. Therefore, in many cases, especially facial damage, invasive growth is often very slow, often before the invasive growth, the patient died for other reasons.

(2) superficial diffuse in situ melanoma: also known as Paget-like in situ black. The disease is the most common malignant melanoma in whites, accounting for about 70%. It is more common in middle-aged people and can occur in any part of the skin, but it is more common in non-exposed areas, especially in the upper part of the back and lower legs. The damage is less than that of malignant freckles, and the diameter is rarely more than 2.5 cm. It is often misdiagnosed as sputum cell sputum. Often light or obvious bulge, irregular shape, the edges are often curved or jagged, and some parts are curved, which is characterized by varying colors and inconsistencies, which can be yellow-brown, brown, light red or even blue or black. At the same time mixed with grayish white. In the case of invasive growth, the rate is much faster than malignant freckle-like sputum, often infiltration, nodules, ulcers or hemorrhage in 1 to 2 years, that is, development of dermal invasive growth, poor prognosis.

(3) acral freckle-like in situ melanoma: acral lentiginous melanoma in situ is more common in black and yellow, and domestic reports are more common. The onset may be related to trauma. Occurs in the palmar, nail bed and nail-free parts of the nail, especially enough. This tumor grows in situ for a short period of time and invasive growth occurs very quickly. Early lesions are pigmented dark spots with varying depths, and the edges are irregular and unclear. If the lesion is located in the nail parent, longitudinal pigmentation streaks may appear in the nail and nail bed.

More common in middle-aged people, can occur in any part of the skin, but more common in non-exposed areas, and especially in the upper back and lower legs. The damage is less than that of malignant freckles, and the diameter is rarely more than 2.5 cm. It is often misdiagnosed as sputum cell sputum. Often light or obvious bulge, irregular shape, often curved or jagged on the edges, some of which are curved, characterized by varying inconsistencies and inconsistencies, yellow-brown, brown, reddish or even blue or black At the same time, it is mixed with grayish white. In the case of invasive growth, the rate is much faster than malignant freckle-like sputum, often infiltration, nodules, ulcers or hemorrhage in 1 to 2 years, that is, development of dermal invasive growth, poor prognosis.

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