The microcirculation of cutaneous malignant melanoma

The microcirculation of human skin tumours can be visualized with noninvasive methods from clinical microcirculation research (capillaroscopy and laser Doppler fluxmetry (LDF). The latter can also be used to measure the blood flow in such tumours. This prospective study was designed to evaluate melanoma-associated cutaneous neoangio-genesis. We studied the microcirculation of 114 pigmented skin tumours in 103 patients (63 women, 40 men) averaging 38.8+/-21.1 years of age. On the basis of histological findings, we diagnosed melanocytic naevus in 86 cases and malignant melanoma in 28. The malignant melanoma was characterized by a chaotic arrangement of the capillaries,which were dilated and formed corkscrew-shaped or glomerular structures. In the transitional area between healthy and cancerous areas there was hypervascularization. The capillaries of the melanoma appeared to be more permeable towards the low-molecular-weight, water-soluble sodium fluorescein. Laser Doppler flux, a measure of cutaneous circulation in the upper 2 mm of the skin,is higher in the centre of the melanoma than in either the middle of a melanocytic naevus (p<0.0005) or in neighbouring healthy skin areas (p<0.005). In the future, antiangiogenetic therapy strategies could play a significant role in the treatment of malignant melanoma. These methods provide a reliable means of evaluating the specific antiangiogenetic efficacy of treatments for cutaneous melanoma.