CAUSATION & DEVELOPMENT  

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CAUSATION & DEVELOPMENT CAUSATION & DEVELOPMENT

Melanoma may arise wherever MELANOCYTES as part of the MELANOCYTIC SYSTEM are present in the body. The highest melanocyte count can be found in the skin, where MELANOCYTES are scattered among the surrounding skin cells at the basal layer of the EPIDERMIS. The EPIDERMIS separates the outward part of the skin surface from the underlying soft-tissue and fat layer underneath. In the above skin section sketches, the EPIDERMIS can easily be recognized by its intense violet tint and its characteristic saw-like horizontal band structure.

While MELANOCYTES are loosely distributed among the adjacent epidermal skin cells (KERATINOCYTES) at the basal epidermal skin layer, they can often be found as MELANOCYTES CLUSTERS at the bottom tip of the so-called EPIDERMAL RETE RIDGES (saw-like epidermis protrusions). This is the location, where MELANOCYTIC NEVI are initially formed through melanocyte aggregation and cellular maturation. However, if this process does not work properly, here the formation of pathological MELANOCYTES may begin, eventually leading to uncontrolled proliferation of atypical and thus pathologic MELANOCYTES, which is then called MELANOMA.

Can you find the EPIDERMIS? Can you find the pathological MELANOMA CELL CLUSTER in the right sketch, indicating the formation of an early MELANOMA out of PATHOLOGICAL MELANOCYTES? (HINT: CLICK ON EITHER SKETCH) This is the area, where the pathologist has to look carefully in a skin biopsy specimen taken, in order to confirm or rule out a MALIGNANT MELANOMA and to perform a tumor parameter assessment, which is then called MICROSTAGING.

What causes MELANOMA? Possible causes for melanoma - as is known to date - are pre-formed or acquired genetic alterations within the MELANOCYTIC SYSTEM, with inadequate UV exposure (intermittent high-dose exposure, sunburns) adversely impacting on regulatory control of melanocyte differentiation.