Dear Dr. Gott: A 38-year-old female relative was recently diagnosed with an internal melanoma. She had a persistent cough, which led to a chest X-ray and then an upper-body scan. Something showed on the lungs, and then a mass was found on the liver. Any information you can provide would be greatly appreciated.

Reply: A melanoma develops in cells that produce melanin. It is a serious form of skin cancer. While the exact cause for the condition remains unknown, it is believed that exposure from the sun, tanning lamps and tanning beds greatly increases the probability of development.

With healthy skin, new cells push older ones upward toward the surface of the skin, where the cells die and are sloughed off. When the process breaks down, new cells grow at an increased rate and can form cancerous cells.

Melanomas can originate in areas such as the gall bladder, intestines and the back of the eye, or they can be the result of one that began on the skin and spread to an internal organ.

There are cases when no lesion is visible on the skin, it is too small to be seen, or is in an area difficult to monitor. However they develop, treatment remains the same. The first step is often surgery to remover the cancerous cells. While this doesn't provide a cure, surgery can buy time to allow for the consideration of other options.

This procedure is often followed by radiation; however, results have been mixed. Chemotherapy alone has not been completely successful, but when used in addition to other types of therapy, such as drugs to slow blood-vessel growth, better results may be found. It appears that melanoma tumours have an increased need for blood when treated with chemotherapy. By cutting off the blood supply, the effectiveness of the combination therapy is greater. Immunotherapy may boost the immune system to fight cancer. Clinical trials are under way to determine its effectiveness.

The bottom line is preventing excessive sun exposure. When a skin lesion changes colour or increases in size, it is vital it be checked out by a primary-care physician or dermatologist.

Early detection is extremely important. If the condition already exists, place yourself under the care of a specialist familiar with melanomas.

Dear Dr. Gott: I once wrote to you about Campho-Phenique curing ringworm. You did not mention that in your ringworm article in the paper. Why?

Reply: Campho-Phenique is purported to relieve the pain and itch of insect bites, as treatment of minor scrapes, burns, sunburn and to provide relief from cold sores. Nowhere on the packaging does it indicate a use for eradicating ringworm.

I apologise for not having acknowledged it as a possibility, but I didn't get to read your letter until after I wrote my column.

I recommend people with ringworm begin with an over-the-counter topical ointment applied according to package directions for two weeks.

If no improvement is noticed, see a physician for a prescription-strength antifungal topical or oral medication. Keep in mind that there can be side effects from pills, and some can interfere with the absorption of these drugs.

Dr. Peter Gott is a retired physician and the author of 'Dr. Gott's No Flour, No Sugar Diet' and 'Dr. Gott's No Flour, No Sugar Cookbook'. Contact him c/o United Media, 200 Madison Avenue, fourth floor, New York, New York 10016.