MALIGNANT TUMOUR arising from melanocytes (see MELANOCYTE). It may start in an existing MOLE or arise anew. Increasing exposure to sunlight of white populations in the 20th century has resulted in an alarming increase in the incidence of this cancer. It is mainly seen in those over 40 years, especially on the legs in women and on the back in men. An enlarging pigmented macule or nodule with irregular contour, profile or colour distribution is always suspect.
is excision with a margin of normal tissue. The specimen must be examined microscopically, and prognosis depends on the depth of invasion. Very superficial melanomas carry an excellent outlook once removed, but if there has been spread to regional lymph glands, further surgery may be needed or entry into a trial of immunotherapy with BIOLOGICS may be advised. Where there has been distant spread, biologics are usually the first option but chemotherapy may be offered with dacarbazine. Some patients with melanoma have a gene mutation, termed BRAF 600, and may be advised targeted therapy with MONOCLONAL ANTIBODY DRUGS such as vemurafenib or dabrafenib.