Peer Reviewed
Feature Article Dermatology
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When is it melanoma? An update on diagnosis and management

Matthew J Lin, John W Kelly

Early diagnosis and treatment of melanoma are crucial to maximise the chances of a favourable outcome.

Key Points
    • Early diagnosis of melanoma is crucial and is enhanced by identification of high-risk groups and appropriate surveillance. In addition to regular full skin examination, total body photography and sequential digital dermoscopic imaging are useful in selected patients.
    • Dermoscopy significantly improves diagnostic accuracy for melanoma and other skin lesions.
    • Clinicians should be aware of atypical presentations (e.g. amelanotic, hypopigmented and nodular melanomas), which are often the most aggressive forms.
    • Excisional biopsy is the ideal biopsy method for suspicious lesions, allowing wide local excision to be based on accurate Breslow thickness.
    • Referral of patients to a multidisciplinary melanoma unit should be considered.
    • Careful follow up is important to detect disease recurrence and subsequent primary melanomas.
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