What should you know about atypical melanoma?

Some melanomas are evenly coloured, pale, pink, red, small, or shaped more regularly than expected. Appearance alone cannot confirm or exclude melanoma; a clinician may examine the lesion with magnification and arrange a biopsy when its history or features are concerning.

Here, atypical describes a melanoma that does not match the classic mental picture of a dark, irregular mole. It may contain little pigment, resemble a harmless growth, or appear under a nail, on a palm or sole, or on skin that is not routinely checked.

Change over time is especially useful. Growth, a new colour, bleeding, crusting, persistent itching, tenderness, or a spot that looks different from a person's other marks can justify examination. These changes have many possible causes, but melanoma commonly presents as a new or changing lesion and must be ruled out by appropriate assessment.

Book a dermatology appointment rather than trying to classify the lesion from a photograph. Note when you first saw it and what has changed. If practical, bring dated photographs and mention previous skin cancers, significant sun exposure, immune-suppressing medicines, and melanoma in close relatives.

The clinician may inspect the whole skin surface and nearby lymph nodes. If tissue sampling is advised, the laboratory report identifies whether melanoma is present and records features that guide staging and treatment. Surgery is commonly used for a localised melanoma; additional lymph-node assessment or medicines depend on the confirmed stage and individual circumstances.

Arrange prompt review for a lesion that is new and persistently growing, changing in colour or shape, repeatedly bleeding without clear injury, failing to heal, or noticeably different from surrounding marks. A dark streak beneath a nail that widens or pigment spreading onto nearby skin also needs assessment.

Contact your cancer team promptly after a melanoma diagnosis if you notice a new lump, unexplained persistent headache, new weakness, breathing difficulty, or ongoing bone pain. These symptoms do not establish spread, but they can require timely examination and testing.

Ask which feature prompted concern, what type of biopsy is planned, whether the entire lesion will be removed, when results should be available, and who will explain them. If melanoma is confirmed, ask what the pathology says about depth and ulceration, whether further surgery or lymph-node assessment is relevant, and what follow-up schedule fits your diagnosis.