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{{CMG}} {{AE}} {{YD}}; {{SSK}}
{{CMG}} {{AE}} {{YD}}; {{SSK}}
==Overview==
==Overview==
==Biopsy==
*Patients who have lesions suspected to be melanoma should always be biopsied.<ref name="pmid23584343">{{cite journal| author=Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A et al.| title=Melanoma, version 2.2013: featured updates to the NCCN guidelines. | journal=J Natl Compr Canc Netw | year= 2013 | volume= 11 | issue= 4 | pages= 395-407 | pmid=23584343 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23584343  }} </ref>
*An excisional biopsy (either elliptical, punch, or saucerization) of the thickest portion of the lesion  with 1-3 mm margins is recommended.<ref name="pmid23584343">{{cite journal| author=Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A et al.| title=Melanoma, version 2.2013: featured updates to the NCCN guidelines. | journal=J Natl Compr Canc Netw | year= 2013 | volume= 11 | issue= 4 | pages= 395-407 | pmid=23584343 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23584343  }} </ref>
*Shave biopsy is acceptable only when the index of suspicion for melanoma is low.<ref name="pmid23584343">{{cite journal| author=Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A et al.| title=Melanoma, version 2.2013: featured updates to the NCCN guidelines. | journal=J Natl Compr Canc Netw | year= 2013 | volume= 11 | issue= 4 | pages= 395-407 | pmid=23584343 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23584343  }} </ref>
*The following should be reported when a biopsy is being reported:<ref name="pmid23584343">{{cite journal| author=Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A et al.| title=Melanoma, version 2.2013: featured updates to the NCCN guidelines. | journal=J Natl Compr Canc Netw | year= 2013 | volume= 11 | issue= 4 | pages= 395-407 | pmid=23584343 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23584343  }} </ref>
:*Location
:*Regression
:*Tumor infiltrating lymphocytes
:*Breslow thickness and vertical growth phase
:*Histologic ulceration
:*Clark level
:*Angiolymphatic invasion
:*Neurotropism
:*Histologic subtype
==Approach to Patients with Suspected Melanoma==
==Approach to Patients with Suspected Melanoma==
The following algorithm illustrates the approach to patients with suspected melanoma.<ref name="pmid23584343">{{cite journal| author=Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A et al.| title=Melanoma, version 2.2013: featured updates to the NCCN guidelines. | journal=J Natl Compr Canc Netw | year= 2013 | volume= 11 | issue= 4 | pages= 395-407 | pmid=23584343 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23584343  }} </ref>
The following algorithm illustrates the approach to patients with suspected melanoma.<ref name="pmid23584343">{{cite journal| author=Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A et al.| title=Melanoma, version 2.2013: featured updates to the NCCN guidelines. | journal=J Natl Compr Canc Netw | year= 2013 | volume= 11 | issue= 4 | pages= 395-407 | pmid=23584343 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23584343  }} </ref>

Revision as of 02:47, 22 August 2015

Melanoma Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Serge Korjian M.D.

Overview

Approach to Patients with Suspected Melanoma

The following algorithm illustrates the approach to patients with suspected melanoma.[1]

 
 
 
 
 
 
 
 
Suspicious pigmented lesion
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Biopsy
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Inadequate
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Rebiopsy
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Melanoma confirmed
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Breslow thickness
 
Ulceration status
 
Mitotic rate
 
Depth and peripheral margin status
 
Presence of satellitosis
 
Clark level for lesions ≤ 1 mm
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Reassessment with complete physical examination, including neurological exam and lymph node assessment
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

References

  1. ↑ Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A; et al. (2013). "Melanoma, version 2.2013: featured updates to the NCCN guidelines". J Natl Compr Canc Netw. 11 (4): 395–407. PMID 23584343.
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