Mr. P.X. age 45, had been swimming and was sitting on the beach when a friend commented on a dark reddishblack “pimple” with a rough surface on it on his upper back. Mr. P.X. said he had numerous...

Mr. P.X. age 45, had been swimming and was sitting on the beach when a friend commented on a dark reddishblack “pimple” with a rough surface on it on his upper back. Mr. P.X. said he had numerous moles on his body and it was not of concern. However, later he thought about the comment and saw his physician, who thought the lesion was suspicious and should be checked. The border and surface of the mass were irregular, and it appeared to be quite thick. A similar small lesion was located nearby. The lesion was diagnosed as a superficial spreading malignant melanoma, and further surgery was scheduled. Surgery revealed that the melanoma had penetrated through the dermis and had spread to the regional lymph nodes.

1. Explain the factors that make this lesion suspicious for cancer.

2. List the possible predisposing factors in this patient.

3. Predict the prognosis and the reasons for it in this case.