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Melanoma

Lloyd A. Runser, MD, MPH, FAAFP and Pratibha Sonam Vashista, DO Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Melanoma is a tumor arising from malignant transformation of pigment-containing cells called melanocytes, which are found in the stratum basale of the epidermis.

    • Most arise in the ski...

DIAGNOSIS

HISTORY

  • Change in a pigmented lesion: either hypo- or hyperpigmentation, bleeding, scaling, ulceration, or changes in size or texture

  • Obtain family and personal history of melanoma or nonmelan...

TREATMENT

GENERAL MEASURES

Full surgical excision of melanoma is the standard of care. See below for recommended surgical margins. 

MEDICATION

  • For stages I to III, surgical excision is curative in most c...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

After diagnosis and treatment, close follow-up and skin protection (i.e., sunblock, UV protective clothing) are highly advised. 

Patient Monitoring

  • Routine screenin...

REFERENCES

1
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin.  2019;69(1):7–34.
2
Swetter SM, Tsao H, Bichakjian CK, et al. Guidelines of care for the management of primary ...

ADDITIONAL READING

CODES

ICD10

  • C43.9 Malignant melanoma of skin, unspecified

  • C43.30 Malignant melanoma of unspecified part of face

  • C43.4 Malignant melanoma of scalp and neck

  • C43.39 Malignant melanoma of other parts of face

  • C...

CLINICAL PEARLS

  • Remember that amelanotic melanomas exist; pigmentation is not required.

  • 70% of melanomas are de novo, not from preexisting nevi. Still, any changing nevi should be biopsied, preferably ...

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