confused

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    • May 18, 2012 at 8:36 pm
    JC
    Participant

      This is something that has always confused me.  If the skin on the back, for example, is thick, with an epidermis and dermis of about 4mm…..then how can a 0.3mm melanoma possibly penetrate into the dermis?  You wouldn't think it would be thick enough to be able to do so.  I don't get it.

      This is something that has always confused me.  If the skin on the back, for example, is thick, with an epidermis and dermis of about 4mm…..then how can a 0.3mm melanoma possibly penetrate into the dermis?  You wouldn't think it would be thick enough to be able to do so.  I don't get it.

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        • May 18, 2012 at 8:50 pm
        Janner
        Participant

          Because the epidermis isn't counted.  By definition, the Breslow depth is the distance from the epidermal / dermal junction into the dermis.  The depth of the epidermis isn't a factor as it is never included in the depth measurements.  So I have no clue how deep YOUR epidermis is (or mine either, for that matter).  All I know is that my melanoma penetrated .58mm into the dermis for #1, was only in situ and confined to the epidermis for #2, and .88mm into the dermis for #3.

          • May 18, 2012 at 8:50 pm
          Janner
          Participant

            Because the epidermis isn't counted.  By definition, the Breslow depth is the distance from the epidermal / dermal junction into the dermis.  The depth of the epidermis isn't a factor as it is never included in the depth measurements.  So I have no clue how deep YOUR epidermis is (or mine either, for that matter).  All I know is that my melanoma penetrated .58mm into the dermis for #1, was only in situ and confined to the epidermis for #2, and .88mm into the dermis for #3.

              • May 18, 2012 at 11:06 pm
              JC
              Participant

                So approx how deep into the dermis does it need to get to access blood vessels, etc…for a mechanism to spread?

                • May 18, 2012 at 11:06 pm
                JC
                Participant

                  So approx how deep into the dermis does it need to get to access blood vessels, etc…for a mechanism to spread?

                  • May 19, 2012 at 3:27 am
                  Janner
                  Participant

                    Lymph and blood vessels are located in the lower dermis, not typically in the papillary dermis (higher level).  But there are no hard and fast rules here and different skin areas will have different characteristics / thicknesses, etc.  I don't there really is a good answer to your question because it is just too variable.   If you're looking for prognostic factors, look to the staging guidelines.  The characteristics they use in staging are the ones that have shown to have real value in predicting spread. 

                    • May 19, 2012 at 3:27 am
                    Janner
                    Participant

                      Lymph and blood vessels are located in the lower dermis, not typically in the papillary dermis (higher level).  But there are no hard and fast rules here and different skin areas will have different characteristics / thicknesses, etc.  I don't there really is a good answer to your question because it is just too variable.   If you're looking for prognostic factors, look to the staging guidelines.  The characteristics they use in staging are the ones that have shown to have real value in predicting spread. 

                      • May 19, 2012 at 3:27 am
                      Janner
                      Participant

                        Lymph and blood vessels are located in the lower dermis, not typically in the papillary dermis (higher level).  But there are no hard and fast rules here and different skin areas will have different characteristics / thicknesses, etc.  I don't there really is a good answer to your question because it is just too variable.   If you're looking for prognostic factors, look to the staging guidelines.  The characteristics they use in staging are the ones that have shown to have real value in predicting spread. 

                        • May 18, 2012 at 11:06 pm
                        JC
                        Participant

                          So approx how deep into the dermis does it need to get to access blood vessels, etc…for a mechanism to spread?

                          • May 19, 2012 at 11:36 am
                          JC
                          Participant

                            So, the thicker the area of skin where the melanoma is, the better?  So, for instance, the back (thicker skin) is better than the foot or hand or ear (thinner skin)?  Wherever there is more skin to have to penetrate, the better?

                            • May 19, 2012 at 11:36 am
                            JC
                            Participant

                              So, the thicker the area of skin where the melanoma is, the better?  So, for instance, the back (thicker skin) is better than the foot or hand or ear (thinner skin)?  Wherever there is more skin to have to penetrate, the better?

                              • May 19, 2012 at 11:36 am
                              JC
                              Participant

                                So, the thicker the area of skin where the melanoma is, the better?  So, for instance, the back (thicker skin) is better than the foot or hand or ear (thinner skin)?  Wherever there is more skin to have to penetrate, the better?

                                • May 19, 2012 at 2:10 pm
                                Janner
                                Participant

                                  In general, yes.  Never a guarantee, but better.

                                  • May 19, 2012 at 2:10 pm
                                  Janner
                                  Participant

                                    In general, yes.  Never a guarantee, but better.

                                    • May 19, 2012 at 2:10 pm
                                    Janner
                                    Participant

                                      In general, yes.  Never a guarantee, but better.

                                    • May 18, 2012 at 8:50 pm
                                    Janner
                                    Participant

                                      Because the epidermis isn't counted.  By definition, the Breslow depth is the distance from the epidermal / dermal junction into the dermis.  The depth of the epidermis isn't a factor as it is never included in the depth measurements.  So I have no clue how deep YOUR epidermis is (or mine either, for that matter).  All I know is that my melanoma penetrated .58mm into the dermis for #1, was only in situ and confined to the epidermis for #2, and .88mm into the dermis for #3.

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