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Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery

Written by Dr. Ringpfeil

Melanoma

Melanoma is the most serious type of skin cancer due to its potential to metastasize to other body organs. People can die from melanoma but melanoma can also be cured by surgery alone if caught early. The incidence of melanoma in the United States has been increasing. Melanoma results from changes within the pigment-producing cells called melanocytes. It can occur on its own or within a pre-existing mole. Melanoma can develop on any part of the skin even those areas not commonly exposed to the sun. It can also develop within the eye.

The risk of developing melanoma increases with age but it is also the most common cancer in women aged 25 to 29. It is rare before puberty. There are different types of melanoma: superficial spreading, nodular, lentigo maligna, and acral lentiginous. Up to 70% of melanomas fall into the category of superficial spreading melanoma. It is commonly found on the backs of men and on the legs of women. It appears as a flat to slightly raised irregularly shaped and colored spot.

It is slow-growing often over a period of years. Nodular melanomas are the next most common. They represent 15% to 30% of melanomas and involve deeper layers of the skin. They are rapidly growing over a period of months and occur as a brown, black, blue, or non-pigmented raised lesion. Lentigo maligna melanoma represents 4% to 10% of melanomas. Lentigo maligna occurs on sun-exposed areas, particularly the face, of older individuals.

It is characterized by an irregularly shaped and irregularly colored flat spot. The least common type of melanoma is the acral lentiginous variety, which represents 2% to 8% of melanomas. This type occurs on the palms and soles and is most commonly seen in black individuals. Acral melanomas can also occur on the bed of the fingernail or toenail and are characterized by a dark streak within the nail.

Diagnosis

Melanomas are diagnosed with a skin biopsy. Melanomas are staged based on the size of the tumor, whether or not lymph nodes are involved and whether or not the cancer has metastasized. The thickness of the lesion and whether or not ulceration is present are also important factors in determining the severity of the melanoma and prognosis. During skin exams, a trained professional will employ the ABCDs of melanoma when evaluating a lesion.

These include "A" for asymmetry, "B" for borders (looking for jagged or irregular borders), and "C" for color (looking for a mixture of brown, black, red, or a lesion that looks significantly different in color than a patient's other moles) and "D" for diameter (anything 6 mm or larger will draw attention but may not indicate concern if none of the other features are present). If a lesion has any suspicious features a biopsy should be performed. After microscopic evaluation by a pathologist, the diagnosis can be made.

Treatment

Melanoma is treated through surgery. The entire lesion needs to be excised with a margin of normal tissue to ensure definitive removal. The width of the safety margin needed is determined by the depth of the melanoma. For thicker melanomas, a sentinel lymph node biopsy (SLNB) may be done to check to see if cancer has spread to the lymphatic system.

Management

It is recommended that an individual who has been diagnosed with melanoma have a complete skin exam every 3 months for the first 1-3 years. After this period skin exams should be performed every 6 months. During these exams, the entire skin surface should be evaluated because melanomas can occur in non-sun-exposed areas. The exam will look for evidence of recurrent or metastatic lesions as well as precursor lesions. All immediate family members should also have an annual complete skin examination.

Coping

Patients who have received a diagnosis of melanoma can receive support through organizations such as the American Melanoma Foundation (www.melanomafoundation.org). They should also check their skin periodically for new or changing lesions and comply with recommendations for a professional skin check.

Prevention

Prevention of melanoma and skin cancers, in general, can be facilitated by strict sun protection through the daily appropriate use of sunscreen and sun-protective clothing. Regular skin checks by a trained professional will also help identify skin cancers and potential precursor lesions.

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SKIN

# of surveys: 3977
Last updated: 11/10/2022 8:45 PM

PATIENT RATINGS

Would you recommend us?

definitely
93.1%
probably
6.16%
maybe
0.58%
not likely
0.08%
no
0.02%

Compare our service to other similar practices

excellent
87.9%
very good
10.1%
good
1.8%
poor
0.06%
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Overall doctor performance

excellent
94.2%
very good
4.89%
good
0.80%
poor
0.03%
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The doctor listened to you attentively

excellent
93.9%
very good
4.97%
good
1.05%
poor
0.05%
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The doctor took time to answer your questions

excellent
94.0%
very good
4.66%
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1.27%
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0.02%
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The doctor explained treatment options

excellent
94.3%
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4.16%
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very poor
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The doctor explained treatment options

excellent
92.0%
very good
5.69%
good
2.18%
poor
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Front desk performance

excellent
85.6%
very good
10.2%
good
3.66%
poor
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very poor
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Aesthetician performance

excellent
88.6%
very good
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very poor
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Office comfort

excellent
90.9%
very good
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Parking

excellent
66.4%
very good
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good
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poor
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Friendliness of the staff during appointment

excellent
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What WE DID WELL

(Answers:674)

The doctor was very attentive.

#12010-12-08 09:37:02

Everything! I appreciate the fact that Dr. Ringpfeil has a great understanding of my medical condition and how it has affacted my skin. I look forward to seeing her for all my future dermatalogical needs. I really needed a wonderful dermatologist and am grateful to Dr. Sandorfi for referring me to Dr. Ringpfeil.

#22011-01-12 12:15:01

I liked the modern office look, and how the doctor was very friendly and listened to everything I said.

#32022-05-09

I especially enjoyed the atmosphere and the music. It made my visit very enjoyable.

#42011-04-15 08:36:16

Dr Ringpfiel is clearly extremely knowledgable, and dhe took the time to listen completely to me about my condition. I really appreciated the time she took with me, and I am confident she is on the right path for treatment.

#52022-02-12

I really liked that I felt as though I was in a warm and friendly environment vs the sterile and cold feel many other physicians offices maintain. I also thought the tablet P.C. was very cool!

#62022-06-11

I enjoyed the fast service and great eviorment. keep up the good work!

#72022-10-07

i was seeing the docter at my appointment time

#82022-08-05

I didn't feel rushed and felt like I was really listened to and taken seriously. I didn't feel like someone was just throwing ointments at me to get me out the door. I really appreciate the care I received here. Thank you.

#92022-10-01

Everyone was lovely and the office looks beautiful.

#102022-08-20

What can we do better?

(answers:373)

Everything was excellent

#12022-07-26

No comments, everything is great.

#22011-02-21 13:37:17

The service was great I don't see anything better u can do!

#32022-11-10

No complaints at all, but since you asked, receptionist today could have been "warmer"

#42010-08-25 10:41:35

You were amazing

#52010-09-28 09:24:38

I was impressed with every step of making the appointment to seeing the physician.

#62010-12-16 12:26:48

This was my very first visit; as a result, some of the questions above jump the gun a bit. However, the initial visit was a pleasant experience.

#72022-08-05

It was a very good visit! Thank You!

#82022-04-28

Everything was excellent.

#92022-05-19

Everything was delightfully pleasant and comforting.

#102011-03-28 09:42:42

Customer Rating : 4.6

Based on 351 ratings
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