Melanoma - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Incidence of melanoma is increasing, with a lifetime risk in the US of 1 in 27 in men and 1 in 40 in women.
Melanoma is the third most common skin cancer, but is the most common cause of skin cancer-related death.
Approximately 17% of patients develop metastatic disease.
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.

Superficial spreading melanoma

From the personal collection of Dr Hobart Walling and Dr Brian Swick.

Quick Reference

History & Exam
- Key Factors
- Other Factors
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Diagnostics Tests
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Treatment Options
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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

Key Articles

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: melanoma - cutaneous [internet publication].[Full Text]
National Institute for Health and Care Excellence. Melanoma: assessment and management. Jul 2022 [internet publication].[Full Text]
Michielin O, van Akkooi ACJ, Ascierto PA, et al. Cutaneous melanoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2019 Dec 1;30(12):1884-901.[Abstract][Full Text]
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]

Other Online Resources

World Health Organization: radiation: the ultraviolet (UV) index
British Association of Dermatologists: skin cancer
National Council on Skin Cancer Prevention
Melanoma Institute Australia
American Academy of Dermatologists: melanoma
Melanoma UK
British Association of Dermatologists: patient information leaflets on melanoma

Referenced Articles

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