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Risk components include the fol lowing: Fair complexion, blue eyes, red or blond hair, and freckles Celtic or Scandinavian origin Tendency to burn and never 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 frequent form; normally impacts center-aged folks, occurs most regularly on trunk and lower extremities Circular lesions with irregular outer parts Margins of lesionfiat or elevated and palpable May seem together of colors, with hues of tan, brown, and black mixed with gray, bluish black, or white; typically a dull, pink-rose shade is famous in a small area inside the lesion Lentigo-Maligna Melanoma Slowly evolving pigmented lesion Occurs on uncovered pores and skin areas; hand, head, and neck in eld erly individuals First seems as tan,fiat lesion, which in time undergoes modifications in dimension and color Nodular Melanoma Spherical, blueberrylike nodule with relatively easy sur face and uniform blue-black shade Cancer of the Skin (Malignant Melanoma) 193 May be dome-formed with a clean surface or have other shadings of red, grey, or purple May appear as irregularly formed plaques C May be described as a blood blister that fails to resolve Invades immediately into adjoining dermis (vertical growth); 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 arms, soles, in nail beds, and mucous membranes in dark-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 too giant to be eliminated safely with out in depth scarring most effective erectile dysfunction pills order viagra plus without prescription. 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