Vulvar melanoma: what to know

Vulvar melanoma may appear as a new or changing dark patch, nodule or irregularly coloured area, but melanoma can also be less obviously pigmented. Bleeding, persistent itching, ulceration or a sore that does not heal should be examined. Diagnosis generally requires a biopsy, followed by review of the tissue and an assessment of whether nearby lymph nodes need evaluation. Melanoma can spread to other organs, so staging guides the care plan.

Arrange prompt review with a gynaecologist, dermatologist or specialist cancer team, and avoid picking or applying irritant products to the area. Bring the date you first noticed the change and any photographs. Treatment may involve Surgical Excision or Skin Cancer Surgery; selected cases may need a Sentinel Lymph Node Biopsy, Tumour Removal Surgery or Immunotherapy. The recommended plan depends on biopsy and staging findings.

Seek prompt assessment for a changing pigmented lesion, new bleeding, ulceration, persistent soreness, a growing nodule or enlarged groin nodes. Urgent care is appropriate for heavy bleeding, severe pain, fever or difficulty urinating. New neurological symptoms during cancer care require immediate medical attention.

What biopsy is needed? What does the pathology show about the melanoma? Do I need staging scans or lymph-node assessment? Which surgery or medicines fit my findings, and how will follow-up be organised?