​Dermatology -Superficial spreading Melanoma

​Dermatology -Superficial spreading  Melanoma 
Superficial Spreading melanoma ( SSM) 
Light-skinned individuals are more likely to develop SSM melanoma (70%), which typically appears on the upper back. It is a morphologically unique lesion that grows very slowly.
Lesions can happen anywhere, at any age, and are typically solitary. The typical age of onset for SSM is between 30 and 50 years old, and it is slightly more common in women than in persons with darker complexion. Precursor lesions, pale skin, childhood sunburns, and a family history of melanoma are risk factors.

There is a raised, level plaque with distinct uneven boundaries and asymmetry.
The pigment variation of SSM is comparable to, but more pronounced than, the color variability found in the majority of LMM. Lesions are tan, brown, or black. A variety of colors, including red, blue, slate-gray, and dark brown, are displayed, along with areas of tumor regression that are gray or slate-gray. The majority are larger than 5 mm at discovery and develop in pigmented lesions that were previously present (dysplastic nevi). The appearance of nodules and papules indicates a shift to vertical development and dermal invasion.

Dermoscopy and biopsy are used to confirm the clinical diagnosis. When complete excisional biopsy is not possible, incisional or punch biopsy can be carried out; however, total excisional biopsy with small margins is the preferred method. Shave biopsies that don't indicate the extent of invasion should not be used.

Treatment consists of fascia-level excision. Make sure that lesion margins are 1 cm for lesions less than 1 mm in thickness, and only biopsy lymph nodes if they can be felt. Make sure the sentinel lymph nodes are biopsied for lesions thicker than 1 mm. After excision, use skin grafts for repair or direct closure. Only remove lymph nodes if they are clinically palpable and show signs of malignancy, or if there are nodal basins containing concealed tumor cells. If there is a chance of recurrence (positive regional lymph nodes, advanced stage), take adjuvant therapy into consideration.