[Diagnosis and follow up of cutaneous melanoma]

The early diagnosis of cutaneous melanoma alone is capable of significantly reducing the morbidity and mortality associated with this tumour. It is pertinent to all physicians who normally observe skin during the clinical examination; who must have a degree of suspicion for all recent or modified pigmented lesions, and should offer a cutaneous follow-up and advise decreased sun exposure in all patients with multiple naevi. The modification of a lesion, intensely black in colour, are the key elements which arouse suspicion of a melanoma and incite either its removal or a specialist opinion. The follow-up of the patient treated surgically for a melanoma is mainly clinical (skin, subcutaneous tissues, lymph node examination) but has to be consistent (more often on a trimesterly basis), systematic, and annual after 5 to 8 years, during the whole life of the patient with a high risk of a second melanoma. Equally, family members of a patient with a melanoma should also be systematically examined.