Clinical Presentation of Cutaneous Melanoma

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Clinical features of melanoma often include:
    • Variegated color
    • Irregular raised surface
    • Irregular perimeter
  • A biopsy should be performed on a:
    • Pigmented lesion that changes in size, configuration, or color
  • The so-called ABCDEs are a mnemonic device to help clinicians and laypersons remember potential early signs of melanoma:
    • A denotes lesion asymmetry
    • B border / surface irregularity
    • C color variegation
    • D diameter greater than 6 mm
    • E a lesion that is elevating, evolving, or enlarging
  • When a patient presents with a lesion suggestive of melanoma, in addition to biopsy:
    • A thorough physical examination must be performed:
      • With particular emphasis on the skin (including the scalp, interdigit webspace, and intertriginous areas), nodal basins, and subcutaneous tissues
  • Clinical Features:
    • Appearance:
      • Melanomas typically present as pigmented lesions, often with irregular borders and color variations
      • They can be black, brown, tan, or even red, white, or blue
      • Amelanotic melanomas:
        • Which lack pigment, can appear pink or flesh-colored, making them more challenging to diagnose
    • ABCDE Criteria:
      • The American Cancer Society recommends using the ABCDE criteria for early detection:
        • Asymmetry:
          • One half of the mole does not match the other
        • Border:
          • Edges are irregular, ragged, notched, or blurred
        • Color:
          • Color is not uniform and may include shades of brown, black, pink, red, white, or blue
        • Diameter:
          • The spot is larger than 6 mm across (about the size of a pencil eraser), although melanomas can be smaller
        • Evolving:
          • The mole is changing in size, shape, or color
  • References:

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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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