Dermatology

Melanoma

Melanoma is malignant melanocytic disease requiring rapid specialist assessment, histological staging and stage-directed treatment; a changing pigmented lesion should not be reassured by a single visual rule.

Definition

Melanoma is a malignant tumour of melanocytes, most often arising in skin but also possible in mucosal, ocular, nail or other sites. Pathological stage depends on primary tumour and metastatic features.

First principles

Melanoma is a clinical and histological diagnosis

Change, asymmetry, irregular border, colour variation and a new or evolving lesion raise suspicion, but dermoscopy and histology determine diagnosis. Breslow thickness, ulceration, mitotic activity, nodal status and metastases guide staging.

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