melanoma

Moles can be seen at birth, but most appear during childhood, increase in adolescence, and can continue to increase in number until about age 40 years. Most moles are harmless, and these benign moles can grow as the child grows. However, when moles change in certain ways, as described below, a skin specialist (dermatologist) should evaluate and possibly monitor them, as they might develop into a type of skin cancer called melanoma. In general, melanomas are rare in children and are treatable if found early.

Author/s:

E Meryl Shychuk, Elyse M C Harris, Lindsay A Thompson

Cutaneous Melanoma: A Review

Megan George — Tue, 26 Aug 2025 14:23:17 +0000

Date Added:

August 26, 2025

Journal/Publication:

JAMA

Publication Date:

August 25, 2025

URL:

Cutaneous Melanoma: A Review

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2025.13074

Keywords

Targeted and Immune Therapy

PMID (1):

40853557

MeSH

Proto-Oncogene Proteins B-raf

sunscreening agents

Hutchinson's Melanotic Freckle

Sentinel Lymph Node Biopsy

Melanoma, Cutaneous Malignant

Immunotherapy

Skin Diseases* / therapy

A review of current knowledge regarding diagnosis and treatment of patients with cutaneous melanoma. James W. Mold, MD, MPH

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Importance: Melanoma, the fifth most common cancer in the US, has increased from 8.8 per 100 000 in 1975 to 28.42 per 100 000 in 2022. Cutaneous melanoma comprises 94% of cases, with 104 960 US cases projected for 2025.

Observations: Cutaneous melanoma presents as a new, changing, or irregularly pigmented skin lesion. Cutaneous melanoma subtypes include superficial spreading (≈70%), lentigo maligna (≈15%), nodular (≈5%), desmoplastic (≈4%), amelanotic (2%-8%), spitzoid (<2%), and acral (≈1%). Risk factors for cutaneous melanoma include UV radiation exposure, skin type (eg, skin that always burns, never tans), presence of benign and atypical nevi, and personal or family history of melanoma. Primary prevention consists of avoiding direct sunlight and indoor tanning, and photoprotection (sunscreen and sun-protective clothing). Based on United States Cancer Statistics data from 1999 to 2021, 77% of patients with cutaneous melanoma had localized disease (involving only the primary site), 9.5% had regional (nodal) disease, 4.7% had distant metastasis, and 8.8% were unstaged. Melanoma staging, which includes tumor thickness and ulceration and presence of lymph node or distant metastasis, ranges from stage 0 (melanoma in situ) to stage IV (distant metastasis). Localized melanoma (stage IA-IIA) is surgically excised, with margins of 0.5 cm to 2 cm based on depth of invasion. Sentinel lymph node biopsy is recommended for cutaneous melanoma that is ulcerated or 0.8 mm or more thick. Following surgery, patients with stage IIB-C melanoma have improved recurrence-free survival with adjuvant anti-PD-1 immunotherapy compared with placebo (hazard ratio [HR] for recurrence or death, 0.62 [95% CI, 0.49-0.79] for pembrolizumab and 0.42 [95% CI, 0.30-0.59] for nivolumab). For stage III disease, recurrence risk is decreased with nivolumab (HR, 0.72 [95% CI, 0.60-0.86]), pembrolizumab (HR, 0.61 [95% CI, 0.51-0.72]), or BRAF + MEK inhibitor therapy (dabrafenib + trametinib) (HR, 0.52 [95% CI, 0.43-0.63]). First-line treatment for distant metastatic or unresectable melanoma is dual checkpoint blockade with ipilimumab (anti-CTLA-4) and nivolumab. In 2017, 10-year melanoma-specific survival rates were 98% to 94% for stage IA-B, 88% to 75% for stage IIA-C, 88% for stage IIIA, 77% to 60% for stage IIIB-C, and 24% for stage IIID. In 2024, patients with distant metastatic or unresectable melanoma treated with ipilimumab and nivolumab had a 10-year overall survival rate of 43%.

Conclusions and relevance: Melanoma is a common cancer in the US. Treatment for stage IA-IIA melanoma is surgical resection. Anti-PD-1 immunotherapy after surgical excision improves recurrence-free survival in stages IIB-C melanoma. For stage III melanoma, anti-PD-1 immunotherapy or BRAF + MEK inhibitor therapy decreases risk of melanoma recurrence. First-line therapy for metastatic melanoma is dual checkpoint blockade with ipilimumab and nivolumab.

Author/s:

Urvashi Mitbander Joshi, Mohammed Kashani-Sabet, John M. Kirkwood

Melanoma crash course

Alex Haga — Tue, 23 Apr 2024 19:58:37 +0000

Date Added:

April 23, 2024

Journal/Publication:

Canadian Family Physician

Publication Date:

April 1, 2024

Issue:

Volume:

Pages:

254-257

URL:

Melanoma crash course

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.46747/cfp.7004254

Keywords

melanoma

PMID (1):

38627006

MeSH

A concise review of melanoma, its epidemiology, causes, diagnosis, and management. James W. Mold, MD, MPH

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Cutaneous melanoma represents about 4% of skin cancers but is responsible for more than 75% of deaths from skin cancer. The incidence of cutaneous melanoma is reported as 25 per 100,000 people in North America and 60 per 100,000 people in Australia and New Zealand. Melanoma diagnoses are increasing worldwide, possibly owing to improved detection; in Canada the largest increase in age-standardized incidence of melanoma has occurred in males, with an increase of 2.2% per year between 1984 and 2019. Mortality rates for melanoma have declined since 2013 due to the use of immunotherapy; however, there has been no noted reduction in mortality among non-White patients or among populations with lower socioeconomic status, with a study demonstrating that these populations have higher incidences of thick melanoma with poorer prognoses.

There is insufficient evidence to support the effectiveness of skin cancer screening in reducing melanoma mortality, with an Australian study published in 2022 finding that skin screening increases the risks of biopsy and melanoma in situ without increasing the detection rate of invasive melanoma, compared with unscreened individuals. The United States Preventive Services Task Force also does not recommend regular skin checks in the average individual as part of age-appropriate screening guidelines. A guideline published by the Canadian Task Force on Preventive Health Care, based on reports from Australia and New Zealand, recommends regular skin examinations for those at high risk of melanoma (Table 1).

Author/s:

Ashton, R., Wilkinson, A.N.