Answer questions by referring to the introduction of the 4 different types of melanoma on a skin cancer website. Note: When

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问题     Answer questions by referring to the introduction of the 4 different types of melanoma on a skin cancer website.
    Note: When more than one answer is required, these may be given in any order. Some choices may be required more than once.
    A = Superficial Spreading Melanoma
    B = Nodular Melanoma
    C = Lentigo Maligna Melanoma
    D = Acral Lentiginous Melanoma
    Which type(s) has/have the trait that...
    Melanoma, also referred to as "malignant melanoma", is the most serious form of skin cancer. It is the skin cancer most likely to spread to lymph nodes and internal organs. There are four most common types of melanoma, which accounts for about 100% of diagnosed cases.
A
    Superficial Spreading Melanoma: Superficial spreading melanoma (SSM) is the most common type of melanoma in the United States, accounting for about 70% of all diagnosed melanoma cases. This type of melanoma can strike at any age and occurs slightly more often in females than males. SSM is the leading cause of death from cancer in young adults.
    When SSM occurs in females, it most commonly appears on the legs. In males, it is more likely to develop between the neck and pelvis. However, this does not mean that females do not get SSM on their trunks or that males do not see SSM on their legs. This melanoma can occur anywhere on the skin’s surface.
    A typical SSM lesion has irregular borders and various shades of black, brown, gray, blue, pink, red, or white. Within the lesion there can be a remarkable variation in color involving white, pink, brown, and black.
    In the early stages, SSM usually appears as a flat spot that looks like a freckle that is spreading sideways on the skin. Over time, the pigmentation in the lesion may darken, and the lesion may grow, develop increasingly irregular borders, and have areas of inflammation within the lesion. The area around the lesion may begin to itch. Occasionally, a SSM may become "less" pigmented as a person’s immune responses try to destroy it.
    Superficial spreading melanoma can progress rapidly.
B
    Nodular Melanoma: Nodular melanoma (NM) is the most aggressive type of melanoma and accounts for about 15% of all melanomas diagnosed in the United States. It can appear anywhere on the body and occurs more often in males than females. It can develop at any age; however, it is most often seen in people aged 60 and older.
    NM is different from other types of melanoma. It tends to grow more rapidly in thickness than in diameter and it may not have a readily visible phase of development. Instead of arising from a pre-existing mole, it may appear in a spot where a lesion did not previously exist.
    Since NM tends to grow deeper more quickly than it does wide and can occur in a spot that did not have a previous lesion, the prognosis is often worse because it takes longer for a person to be aware of the changes.
    NM is most often darkly pigmented; however, some NM lesions can be light brown or even colorless (non-pigmented). A light-colored or non-pigmented NM lesion may escape detection because the appearance is not alarming. An ulcerated and bleeding lesion is common.
C
    Lentigo Maligna Melanoma: Lentigo maligna melanoma (LMM) typically occurs on sun-damaged skin in the middle-aged and elderly, especially on the face. This melanoma may be mistaken in its early, and most treatable, stages for a benign "age spot" or "sun spot". LMM accounts for about 10% of the melanomas diagnosed in the United States. Since LMM is so easily mistaken, it can go undetected for years. This can be quite dangerous.
    LMM begins as a spreading, flat, patch with irregular borders and variable colors of brown. This lesion is called "lentigo rnaligna". This spreading brownish patch may grow slowly for years and is often mistaken for lentigo simplex—a benign (non cancerous) brownish patch that can develop in the elderly after years of sun exposure.
    As the lesion grows and evolves, both the pigmentation and borders tend to become more irregular. This often occurs slowly over a period of 10 to 15 years. It also can happen rapidly—in a matter of weeks or months. As the lesion grows deeper into the skin (thickness increases), it may become various shades of black and brown. Dark nodules may appear within the irregular borders. These nodules me the invasive tumor, and if large enough to be felt by touch, will feel lumpy.
D
    Acral Lentiginous Melanoma: In the United States, acral lentiginous melanoma (ALM) accounts for about 5% of all diagnosed melanomas. It also is the most common form of melanoma in Asians and people with dark skin, accounting for 50% of melanomas that occur in people with these skin types.
    ALM is sometimes referred to as a "hidden melanoma" because these lesions occur on parts of the body not easily examined or not thought necessary to examine. ALM develops on the palms, soles, mucous membranes (such as those that line the mouth, nose, and female genitals), and underneath or near fingernails and toenails.
    ALM is often overlooked until it is well advanced because in the early stages, it often looks like a bruise or nail streak.
    As an ALM tumor increases in size, it usually becomes more irregular in shape and color. However, some ALM lesions can be lightly colored or colorless. The surface of the ALM lesion may remain flat, even as the rumor invades deeply into the skin. Thickening ALM on the sole of the foot can make walking painful and be mistaken for a plantar wart.

选项 A、 
B、 
C、 
D、 

答案D

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