Melanoma is the most dangerous type of skin cancer. It is the leading cause of death from skin disease. It involves cells called melanocytes, which produce a skin pigment called melanin. Melanin is responsible for skin and hair colour.Melanoma can also involve the colour part of the eye. Although it is less common than other types of skin cancer, the rate of melanoma is steadily increasing. Melanoma may appear on normal skin, or it may begin at a mole or other area that has changed in appearance. The development of melanoma is related to sun exposure, particularly to sunburns during childhood, and is most common among people with fair skin, blue or green eyes, and red or blond hair. Unlike these previous facts, the authors have been treated during the last 3year seven patients all of them from Zulu ethnic. Here the authors present a 61 years old female patient who was diagnosed of melanoma by SLN [Sentinel Lymph Node] biopsy on the Right groin on September 2008; the patient defaulted from Vryheid Hospital Out Patient Department until October 18 2008 when she came back to Casualty for presenting a fungous ulcer on the Rt. Foot and necrotic lymph nodes on the Rt. Groin area. A small bowel fistula was diagnosed as well. After being treated from her weakness / deteriorated health conditions, the patient was operated first on 23/10/08 [Rt. below Knee Amputation + debridement necrotic lymph node area + catheterization of the bowel fistula]; second 13/11/08 [debridement, resection & repair of fistula, prolene mesh repair of rt. groin]. The patient underwent chemotherapy with dacarbazine ( DTIC), immunotherapy with interferon (IFN)) as well as local perfusion. It is remarkable the increasing number of patients of Zululand community affected by Acral lentiginous melanoma, that is the least common form of melanoma. Introduction The French physician René Laennec was the first to describe melanoma as a disease entity. His report was initially presented during a lecture for the Faculté de Médecine de Paris in 1804 and then published as a bulletin in 1806[1] Generally, an individual's risk for developing melanoma depends on two groups of factors: intrinsic and environmental [2, 3] A family history of melanoma greatly increases a person's risk because mutations in CDKN2A, CDK4 and several other genes have been found in melanoma-prone families [4]There are 4 major types of melanoma: Superficial spreading melanoma is the most common type of melanoma. It is usually flat and irregular in shape and color, with varying shades of black and brown. It may occur at any age or body site, and is most common in Caucasians. Nodular melanoma usually starts as a raised area that is dark blackish-blue or bluish-red, although some are without color. Lentigo maligna melanoma usually occurs in the elderly. It is most common in sun-damaged skin on the face, neck, and arms. The abnormal skin areas are usually large, flat, and tan with intermixed areas of brown. Acral lentiginous melanoma is the least common form of melanoma. It usually occurs on the palms, soles, or under the nails and is more common in African The Vryheid Hospital multidisciplinary team has already included into its protocols related to cancer the identification of some risk factors: Family history of melanoma Red or blond hair and fair skin Presence of multiple birthmarks Development of precancerous lesions Obvious freckling on the upper back Three or more blistering sunburns before age 20 Three or more years spent at an outdoor summer job as a teenager High levels of exposure to strong sunlight As we mentioned before, the authors’ experiences in Melanoma diseases are in treating African Zulu patients. This local incidence into the Zulu populations could be explained due to particular environmental conditions, severe pandemic of AIDS diseases or/ and genetics predisposition. Vryheid Hospital Health team encourages on Out Patient Department, Casualty and peripheral clinics level the knowledge of
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