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Risk factors embrace the fol lowing: Fair complexion, blue eyes, purple or blond hair, and freckles Celtic or Scandinavian origin Tendency to burn and not tan; signicant historical past of extreme sunburn Older age; residence within the southwestern United States Family or private history of melanoma, the absence of a gene on chromosome 9P, presence of giant congenital nevi Dysplastic nevus syndrome Clinical Manifestations Supercial Spreading Melanoma Most widespread kind; usually impacts center-aged individuals, happens most incessantly on trunk and lower extremities Circular lesions with irregular outer parts Margins of lesionfiat or elevated and palpable May appear together of colours, with hues of tan, brown, and black blended with gray, bluish black, or white; typically a dull, pink-rose colour is famous in a small space inside the lesion Lentigo-Maligna Melanoma Slowly evolving pigmented lesion Occurs on uncovered pores and skin areas; hand, head, and neck in eld erly people First appears as tan,fiat lesion, which in time undergoes adjustments in dimension and shade Nodular Melanoma Spherical, blueberrylike nodule with relatively smooth sur face and uniform blue-black color Cancer of the Skin (Malignant Melanoma) 193 May be dome-shaped with a clean surface or produce other shadings of red, gray, or purple May appear as irregularly formed plaques C May be described as a blood blister that fails to resolve Invades immediately into adjacent dermis (vertical development); poor prognosis Acral-Lentiginous Melanoma Occurs in areas not excessively exposed to sunlight and where hair follicles are absent Found on the palms of the palms, soles, in nail beds, and mucous membranes in darkish-skinned folks Appears as an irregular pigmented macule that develops nodules Becomes invasive early Assessment and Diagnostic Methods Excisional biopsy specimen; incisional biopsy when the sus picious lesion is simply too large to be eliminated safely without extensive scarring. 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