What anatomy is relevant to melanoma?

Updated: Jun 28, 2021
  • Author: Jonathan B Heistein, MD; Chief Editor: Gregory Gary Caputy, MD, PhD, FICS  more...
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The skin is composed of multiple layers. The epidermis is the most superficial layer, and it contains keratinocytes in various stages of development. Melanocytes are located in the deepest layer of the epidermis. A basement membrane separates the epidermis from the underlying dermis, which is divided into 2 zones, papillary dermis and reticular dermis. Subcutaneous tissue is deep to the reticular dermis.

In 1874, Sappey performed an anatomic study of cutaneous lymphatic drainage, which is the foundation for current knowledge of this subject. [11] Sappey's results demonstrated the lymphatic drainage based on anatomic location. His findings were modified later, but then the advent of lymphoscintigraphy led to more accurate lymphatic mapping. Norman et al then redefined the lymphatic basins in a definitive report. [12] They concluded that an extensive overlap of basins drains the head, neck, shoulders, and trunk and that a specific basin cannot be predicted based on cutaneous location. Perform lymphoscintigraphy to define the exact lymphatic drainage for each patient.

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