Leonard works in the agriculture industry and raises beef cattle. At 60 years of age, he has spent most of his life working outdoors harvesting hay and tending to his herds
His wife was the first to notice a change in his skin. One day, after taking off his shirt, she noticed a significant change in the mole he had on his right shoulder. It not only was darker but was moist and appeared to have been bleeding at one point. Surrounding the mole, his skin was red. His wife remembered hearing stories of Leonard working on his father's farm, spending long hours out in the hot sun even though his father had gone into the barn to work during the hottest part of the day. She insisted him go to the family physician to have it examined.
Leonard's physician performed a biopsy on the lesion and told Leonard he suspected the growth may be malignant melanoma. What cells are affected in this form of skin cancer? How might his childhood exposures to the sun predispose him to this form of cancer?
How do UVA and UVB rays contribute to the process of oncogenesis in skin cells?
The mole on Leonard's shoulder was a nevocellular nevus. What are the cellular composition and appearance of this type of mole before it underwent malignant change?
Melanocytes are the cells affected in malignant melanoma. Sudden and intense bursts of sun exposure are associated with this form of cancer. A history of either three or more blistering sunburns or three or more outdoor jobs before the age of 20 increases the risk of developing malignant melanoma.
Cellular DNA readily absorbs UV radiation and is directly damaged as a result. UV radiation also reduces the number of Langerhans cells and hinders the immune functions of the skin. Normal immune function is thought to contribute to the destruction of cells with malignant potential. When immune cells are depleted, this protective mechanism is lost.
Nevocellular nevi are composed of melanocytes in the deepest layer of the epidermis. The structure of the melanocytes undergoes transformational change so that they become rounder and grow in clusters within the junction between the epidermis and dermis. The nevi have a uniform, pale to dark brown color. They are small in size and have regular, well-demarcated borders.
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