Melanomas represent less than 1% of malignant eyelid tumours (Figure 6.7). Pigmented BCCs are ten times more common than melanoma as a cause of pigmented eyelid tumours. Forty per cent of eyelid melanomas are, however, non-pigmented.
• Irregular borders
• Variegated pigmentation often with inflammation
• Occasional bleeding
Occasionally the eyelid may be secondarily involved by a conjunctival melanoma.
• Lentigo maligna melanoma
• Superficial spreading melanoma
• Nodular melanoma.
Superficial spreading melanoma appears typically as a brown lesion with shades of red, white and blue - it is initially flat but becomes nodular with increase in vertical growth. Nodular melanoma appears as a nodule or plaque, is dark brown or black in colour but can be amelanotic. It shows little radial growth, but extensive vertical growth (Figure 6.7).
Two classic histologic classifications are based on:
• Anatomic level of involvement (Clark)
• Tumour thickness (Breslow).
Tumour thickness is the most important predictor of prognosis. The average time to metastasis for cutaneous melanomas varies according to tumour thickness. The late onset of widespread disease is rare (cf. choroidal melanomas).
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Complete Guide to Preventing Skin Cancer. We all know enough to fear the name, just as we do the words tumor and malignant. But apart from that, most of us know very little at all about cancer, especially skin cancer in itself. If I were to ask you to tell me about skin cancer right now, what would you say? Apart from the fact that its a cancer on the skin, that is.