Malignant Melanoma

In the United States the incidence of malignant melanoma is increasing at an alarming pace.

For people born in 1930, the risk of developing malignant melanoma at some point in their lives was then 1:1500. A baby born today has a lifetime risk of 1:55.

The death rate for malignant melanoma has also increased dramatically, doubling over the last 35 years. One person dies from melanoma every hour in the U.S. In contrast, in Queensland, Australia, where the first comprehensive education program on malignant melanoma was established for the medical profession and for the public, the death rate for this disease has begun to decrease. This decline in the death rate is especially impressive since the number of cases of malignant melanoma in Queensland, a very sunny part of the world, has continued to rise.

It is now possible to predict with considerable accuracy which malignant melanomas are curable and which are not. Thickness of the tumor is a key factor. Malignant melanomas that are removed when they are less than 3/4 of a millimeter in thickness are cured in virtually all cases, as long-term follow-up has repeatedly confirmed. However, progressively thicker malignant melanomas have correspondingly poorer prognoses.

Given these facts, it is essential that members of the medical profession, the allied health fields, and the public at large be able to recognize early (thin) malignant melanomas, which can be so successfully treated. At Treasure Coast Dermatology, Dr. Ioannides is trained in recognizing and treating these types of skin cancers.


Basal Cell Carcinoma

Malignant Melanoma

Squamous Cell Carcinoma


Any one or more of these changes occurring in a new or existing pigmented (tan, brown) area of the skin, or in a mole, may indicate the presence of a malignant melanoma:

  • Change in size: especially sudden or continuous enlargement
  • Change in color: especially multiple shades of tan, brown, dark brown, black; the mixing of red, white and blue; or the spreading of color from the edge into the surrounding skin
  • Change in shape: especially the developing of an irregular, notched border, which used to be regular
  • Change in elevation: especially the raising of a part of a pigmented area that used to be flat or only slightly elevated
  • Change in surface: especially scaliness, erosion, oozing, crusting, ulceration, or bleeding
  • Change in surrounding skin: especially redness; swelling; or the developing of colored blemishes next to, but not part of, the pigmented area
  • Change in sensation: especially itchiness, tenderness, or pain
  • Change in consistency: especially softening or hardening


In general, the risk of developing malignant melanoma increases as people grow older. In addition, individuals living in the Sun Belt (i.e., closer to the equator) are at greater risk. Caucasians are affected ten times more often than other ethnicities.

Beyond these general considerations, several specific factors identify individuals prone to develop this tumor. People at high risk are those who have:

  • A family history of malignant melanoma
  • Had a malignant melanoma in the past
  • Unusual – “dysplastic” – moles (often larger than 1/4 inch, irregular in shape, and multi- colored)
  • Fair skin, light hair, and light eye color, and a tendency to sunburn easily and to tan with difficulty
  • Large brown moles at birth
  • A record of painful or blistering sunburns, especially when young
  • Indoor occupations and outdoor recreational habits
  • Considerable outdoor exposure, especially while living in sunny regions