Avoiding Delayed Diagnosis of Malignant Melanoma

Delayed diagnosis of melanoma directly impacts patient survival. When obtaining histology of a lesion suspicious for melanoma, the entire lesion should be removed whenever possible. Doing so allows the pathologist the best chance of making the correct diagnosis. Performing full skin exams is important because melanoma can occur anywhere on the cutaneous surface. Patient self-exams, watching for new and changing lesions, are also an important part of early diagnosis. Not all melanomas will exhibit the classic ABCDs (asymmetry, irregular border, variegated color, and diameter greater than 6 mm). Approximately 6% of melanomas do not display these features and can be clinically nondescript, often being diagnosed late. Clinicians should always be suspicious of changing lesions.