Desmoplastic melanoma is a rare form of skin cancer that involves cancerous cells along with fibrous tissue and a high volume of collagen.

People with desmoplastic melanoma often have patches of thickened skin that may resemble scars. These patches are cancerous growths, and they are most common on the head and neck.

This form of melanoma primarily affects individuals over the age of 60 years and people with light skin tones. It is also more common in males than females.

Desmoplastic melanoma may have a higher survival rate than other forms of melanoma.

This article discusses desmoplastic melanoma in more detail, including its symptoms, causes, and treatment. It also explores how doctors may diagnose desmoplastic melanoma and provides information about life expectancy for people with the condition.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms, “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

Black and white image of a person over a light red image of desmosplastic melanoma under a microscopeShare on Pinterest
Photography courtesy of LWozniak&KWZielinski/Wikimedia & Eva Blanco/Getty Images

Desmoplastic melanoma represents less than 4% of primary cutaneous melanomas. This refers to a subtype of malignant melanomas that arise from melanocytes (pigment-producing skin cells).

A few of the most common symptoms of desmoplastic melanoma include:

  • patches of skin that look like scars and have variable texture
  • skin lesions that appear like thickened skin
  • growths that are pink or the same tone as a person’s skin
  • growths that are 6 millimeters (mm) or more in size

Certain desmoplastic melanoma growths may also bleed, itch, or sting.

In some cases, the growths may look like benign skin growths or other types of skin cancer, such as carcinomas. A healthcare professional can properly identify the symptoms of desmoplastic melanoma. Therefore, a person should speak with a doctor if they notice changes in their skin.

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Desmoplastic melanoma is closely related to sun exposure. The majority of desmoplastic melanomas appear on the head and neck. These two areas of the body are particularly susceptible to sun exposure. However, researchers do not fully understand the underlying causes of the condition.

People at the highest risk of this melanoma are generally white, male, and older than 60 years. A few risk factors for desmoplastic melanoma include:

  • having sun-damaged skin
  • having fair skin that is susceptible to sunburn
  • having a prior melanoma diagnosis

Individuals who may be at risk of desmoplastic melanoma should consider attending regular skin cancer screenings. A healthcare professional can identify potential risk factors and provide guidance for each individual.

Information about the treatment options for desmoplastic melanoma is limited because the condition is rare. The most effective treatment for each case depends on the individual and the disease stage they are experiencing.

There are a variety of possible treatments for desmoplastic melanoma:

Surgical treatment

Desmoplastic melanoma may present with thicker growths than other melanomas. Therefore, doctors may recommend surgical removal of larger sections of affected skin.

It is important to note that a doctor will consider the thickness and location of desmoplastic melanoma when deciding if surgical treatment is the best approach.

Radiotherapy

Some people with desmoplastic melanoma may have radiotherapy in addition to surgical treatment. Some research suggests that the addition of radiotherapy can decrease the chance of melanoma recurrence.

That being said, the number of studies examining radiotherapy for desmoplastic melanoma remains limited. Further research into radiotherapy for the condition is necessary.

Individuals interested in pursuing radiotherapy for desmoplastic melanoma should speak with their doctor to determine whether this option is right for them.

Immunotherapy

Immunotherapy works by using a person’s own immune system against the disease they are treating. These therapies may boost the immune system’s natural functions. Or they may involve synthetic substances that work like parts of the natural immune system.

One 2018 study investigated the use of immunotherapy to treat desmoplastic melanoma. This study analyzed 60 people who had advanced desmoplastic melanoma. Researchers found that 70% of the study participants demonstrated improvement. And 32% of these people had a complete recovery.

In cases of advanced desmoplastic melanoma, immunotherapy may be an effective treatment option. However, no one treatment is right for everyone. People considering their treatment options should work with a medical team to develop a personalized care plan.

Targeted therapies

Studies have shown that certain genetic mutations are associated with desmoplastic melanoma. Therefore, gene-replacement therapy may be an option in the future for individuals with known mutations.

Researchers have also found that cases of desmoplastic melanoma are often associated with mutations in multiple genes. This could make targeted therapy more complicated, as it would need to address multiple genes. Therefore, combination therapy may be a better option for many individuals with desmoplastic melanoma.

However, many types of gene-mutation-directed therapy are still undergoing clinical trials and further research. As a result, this type of therapy may not be widely available at present.

Desmoplastic melanoma is a type of skin cancer that is difficult for doctors to diagnose. A recent Chinese study found that only 27% of cases were accurately diagnosed after an initial examination.

Healthcare professionals diagnose desmoplastic melanoma based on a number of factors. The shape of the cells in a particular sample may indicate the presence of the cancer. Certain protein markers like S-100 and SOX-10 may also be present.

Genetic analysis of tissue samples may further aid in diagnosis. The deletion of the CDKN2A gene, for example, is common in desmoplastic melanoma.

Ultimately, diagnosis may not be straightforward. Multiple specialists may need to work together to carry out several different tests. Doctors may use diagnostic tests such as dermoscopy (or dermatoscopy) and skin biopsy.

One 2019 study found that the overall 5-year survival rate for desmoplastic melanoma is 75%. However, there is a lack of data about this condition, making it difficult to define an accurate outlook and life expectancy.

Early diagnosis and treatment may increase a person’s chance of recovery. Factors such as age and overall health may also contribute to someone’s outlook and life expectancy.

A person may consider speaking with a doctor to learn more about the outlook for desmoplastic melanoma and what steps they can take to maximize the chances of successful treatment.

Desmoplastic melanoma is a rare form of skin cancer that doctors may find difficult to diagnose.

Treatment for this condition ranges from surgery to immunotherapy. There is no single treatment plan that is right for everyone. A doctor can help plan and oversee a treatment regimen specific to a person’s unique needs.

Desmoplastic melanoma may have a high recovery rate depending on a range of individual factors. People who may be at risk of developing the condition should consider regular skin cancer screening with a medical professional.