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Highlights & Basics
- Melanoma is among the most common forms of cancer, and causes of cancer-related death, in young adults.
- Reducing exposure to ultraviolet light is critical for primary prevention of melanoma.
- Clinical features of lesion asymmetry, border irregularity, color variability, diameter >6 mm, and evolution over time should raise suspicion for melanoma and prompt further assessment with dermoscopy.
- The prognosis depends on the stage at diagnosis. Over 99% of patients with in-situ melanoma will be cured with simple excision.
- Targeted therapies such as immune checkpoint inhibitors and BRAF inhibitors have revolutionized the treatment of metastatic melanoma. Five-year survival rates have improved since the approval of these therapies and are now approaching 30%.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Superficial spreading melanoma
Nodular melanoma
Subungual melanoma in situ
Fitzpatrick skin type
Dermoscopy: the most important application of dermoscopy is distinguishing melanoma from benign melanocytic lesions
Key dermoscopic features of melanoma: (A) Melanoma presenting with atypical globules and dots of different sizes and shapes (yellow arrows), patches of atypical network (blue arrowhead) and a blue-white veil (blue arrow). (B) Melanoma with diffuse polymorphous vasculature, consisting of serpentine, dotted, and glomerular vessels, can be found throughout the lesion (yellow arrowheads); in addition, patches of atypical network (blue arrowheads) are seen. (C) Superficial spreading melanoma with pseudopods distributed asymmetrically around the lesion (black arrowheads). (D) Melanoma with the regression structure blue-gray peppering (black star); shiny white lines are also seen throughout the entire lesion (red arrows) along with a central blue-white veil (red arrowhead)
Bluish-white veil of a melanoma
Photomicrograph of melanoma in situ
Photomicrograph of Clark level IV invasive melanoma
Citations
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Seth R, Agarwala SS, Messersmith H, et al. Systemic therapy for melanoma: ASCO guideline update. J Clin Oncol. 2023 Oct 20;41(30):4794-820.[Abstract][Full Text]
Vogelbaum MA, Brown PD, Messersmith H, et al. Treatment for brain metastases: ASCO-SNO-ASTRO guideline. J Clin Oncol. 2022 Feb 10;40(5):492-516.[Abstract][Full Text]
- World Health Organization: radiation: the ultraviolet (UV) index
- British Association of Dermatologists: skin cancer
- National Council on Skin Cancer Prevention
- Melanoma Institute Australia
- CDC: skin cancer: sun safety facts
- MIA: risk prediction tools
- ESMO: IO102-IO103 cancer vaccine plus pembrolizumab for first-line (1L) advanced melanoma: primary phase III results (IOB-013/KN-D18)
- American Academy of Dermatologists: melanoma
- Melanoma UK
- British Association of Dermatologists: patient information leaflets on melanoma
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