Overview

Melanoma is the most dangerous form of skin cancer, developing in melanocytes (pigment-producing cells). Although less common than BCC or SCC, it accounts for the majority of skin cancer deaths. Caught at stage 1, the 5-year survival rate exceeds 95%. Melanoma can affect all skin tones, including palms, soles, and nail beds in darker-skinned individuals.

Symptoms

• Use the ABCDE rule: Asymmetry, Border (irregular/ragged), Colour (multiple shades), Diameter (over 6mm), Evolving (any change in size, shape, colour, or new bleeding/itching)
• New moles appearing after age 40; unusual moles on palms, soles, or under a nail
• Acral lentiginous melanoma (palms/soles/nails) is NOT UV-related and affects all skin tones equally

Causes & Risk Factors

• UV radiation causing melanocyte DNA mutations
• Personal or family history of melanoma; many or atypical moles (more than 50)
• Fair skin; history of blistering sunburns; weakened immune system; tanning bed use

Complications

• Metastasis to lymph nodes, lungs, liver, brain, and bones
• Significant morbidity and mortality in advanced disease

Diagnosis

Full skin examination with dermoscopy. Excisional biopsy of suspicious lesions. Sentinel lymph node biopsy for staging. CT/PET-CT/MRI for metastasis. BRAF mutation testing to guide targeted therapy.

Treatment

• Wide local surgical excision; sentinel lymph node biopsy
• Immunotherapy: pembrolizumab, nivolumab, ipilimumab — revolutionary treatments dramatically improving survival
• Targeted therapy: BRAF/MEK inhibitors (dabrafenib + trametinib) for BRAF-mutated melanoma

Prevention

• Daily SPF 50+ sunscreen, reapplied every 2 hours outdoors — critical in Kuwait
• Never use tanning beds; avoid peak UV hours (10am-4pm)
• Monthly ABCDE self-examination; annual full-body skin checks by a dermatologist
• Report any changing or new unusual lesion immediately

Ready to take the next step? Book a consultation today