Superficial spreading melanoma, also known as SSM, is one of the most common types of melanoma accounting for almost 70% of all diagnosed cases. It is the leading cause of cancer among young adults and can appear anywhere on the body, but tends to develop on the upper body of males and the lower legs of females. SSM looks similar to freckles, but rapidly grows vertically on the skin. In its early stages, SSM is not life threatening to the patient as long as an early diagnosis is obtained followed by prompt treatment.
SSM occurs in two phases:
Radial Phase: The lesion grows on the epidermis or the upper layer of the skin and appears thin. It can remain within this phase for months, even years and is the least life-threatening from of SSM.
Vertical Growth Phase: The lesion appears deep within the skin’s surface. This form of SSM has the ability to spread to surrounding tissues, resulting in a more life-threatening condition.
Risk factors associated with SSM include:
- Number of Moles: People with 100 or more moles have increased SSM risk.
- Family History: Most patients with SSM have a parent or sibling with the disease.
- Weakened Immune System: Organ transplants and certain medication that weaken the immune system may lead to superficial spreading melanoma development.
- Sun exposure: Over exposure to sun rays, especially in adolescence, is the leading cause of SSM.
- Xeroderma Pigmentosum: This rare, heredity skin disease, caused by a defect in the enzyme that normally repairs ultra-violet damaged DNA, may lead to superficial spreading melanoma.
- Sex: Women are more likely than men to develop SSM.
Signs and Symptoms
The most common technique to detect superficial spreading melanoma is the acronym ABCDE:
Asymmetrical skin lesion
Border of area is irregular
Color varies from brown, to tan or pink (cracking, bleeding, and itching can also occur)
Diameter of mole is greater than 6mm causing pain and sensitivity
Evolution of mole is a sign of malignancy
Superficial Spreading Melanoma Prognosis
The prognosis of SSM is favorable if a patient receives early diagnosis and proper treatment.
If SSM runs in a patient’s family, it is advised to have annual skin exams. Self-examination is also effective. Taking progressive photographs of the skin lesion will help a dermatologist analyze the disease’ behavior.
Everyone should wear quality sunscreen with an SPF rating of 30 or higher.
Diagnosis and Staging
SSM is diagnosed via biopsy. A biopsy is a procedure in which tissues are extracted to be examined under a microscope. More specifically, a punch biopsy is the diagnostic method of choice for SSM. This procedure involves taking several small samples of the lesion as opposed to extracting the entire lesion.
Other diagnosis options include: X-rays, CT scans, MRIs, PET and PET/CTs, ultrasounds, and LDH testing.
Once a patient is diagnosed, the next step is removing the abnormal mole which usually leaves a scar. Surgery, where a wide, local incision is made is the most common superficial spreading melanoma treatment option, but this can result in a high risk of the lesion returning.
Radiation therapy (the use of ionizing radiation beams to kill cells) and chemotherapy (the use of chemical agents to kill cells) are sometimes used to treat SSM. These treatment modalities yield mixed results.
Once the lesion is removed, it should be submitted for microscopic evaluation. Recurrence once the cancerous lesion is removed is common. As a result, frequent followup visits to your doctor, dermatologist, or skin care specialist are recommended following treatment.