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Melanoma Guidelines from the Finnish Medical Society Duodecim.

Finnish Medical Society Duodecim

Wiley Interscience. John Wiley & Sons; 2010 Jun 4 

Essentials

  • Any suspicious naevus can be removed in primary health care.
  • Melanoma should be suspected if a pre-existing naevus (mole) on the skin increases in size, changes colour, bleeds or discharges purulent material. The presence of so-called "satellite lesions" are also suggestive of melanoma. Melanoma may also develop on a previously healthy skin or mucous membrane.
  • A changed lesion suspected to be melanoma must be excised as soon as possible for an accurate histopathological diagnosis. If it is not possible to remove the lesion as a whole, a biopsy can be taken.
  • If there is a strong suspicion of melanoma, the patient should be referred directly to the care of a surgeon.

Epidemiology and Risk Factors

  • Melanoma is currently the most rapidly increasing malignancy in white populations.
  • Exposure to ultraviolet radiation through sunlight is the major risk factor.
  • Melanoma cannot be excluded based on clinical presentation alone (See Pictures 1 and 2 in the original guideline document), and it may develop on a previously healthy looking skin. The specificity of clinical checklists designed to detect the presence of melanoma can be fairly good, but their sensitivity is limited (Whited & Grichnik, 1998) [C].