Dermal melanoma: what to know about a suspicious skin lesion

Melanoma is a cancer of pigment-producing cells. It may appear in an existing mole or as a new mark. Warning features include asymmetry, an uneven border, several colours, growth, and a change in itch, bleeding, crusting, or sensation. These signs do not prove melanoma, and a harmless lesion can look unusual; a clinician must examine it rather than relying on a photograph or home test.

Assessment may include a skin examination, dermoscopy, and removal of all or part of the lesion for laboratory diagnosis. If melanoma is confirmed, the result guides discussion of depth, nearby lymph nodes, and whether scans or further staging are needed. The word melanoma does not by itself describe how far a cancer has spread.

Arrange a dermatology appointment promptly for a changing or suspicious lesion. Do not pick, burn, or attempt to remove it at home. Photographing the area beside a ruler can help you describe change, but it should not delay assessment. Bring information about when it appeared, how it changed, previous skin cancers, family history, and medicines.

Treatment depends on the confirmed stage and may include surgical excision or other skin cancer surgery. Some people need sentinel lymph node biopsy to assess nearby drainage. More advanced disease may lead to discussion of tumour removal surgery, immunotherapy, or specialist monitoring. Follow-up after cancer treatment helps clinicians check the treated area and examine the rest of the skin.

Seek prompt medical review for a new or changing pigmented mark, spontaneous bleeding, persistent crusting, rapid enlargement, or a sore that does not heal. Urgent care is appropriate for severe bleeding, spreading redness with fever, or new neurological symptoms such as weakness, confusion, seizure, or severe headache. A skin change should not be judged by how common it seems.

Ask what features were concerning, whether tissue diagnosis is needed, how much skin will be removed, when results will be available, and whether lymph-node assessment or imaging is appropriate. If melanoma is confirmed, ask about stage, treatment choices, follow-up visits, sun protection, and which new symptoms should be reported.