[Malignant melanoma: standards and innovation in diagnostics and therapy]

Cutaneous malignant melanoma originates from neoplastic proliferation of melanocytes. Due to its early lymphogenic and haematogenic metastazing, melanoma belongs to the most malignant tumours. The disease occurs quite early; one quarter of patients with melanoma is younger than 40 years and the mean age of a melanoma patient is 54 years. The incidence of this tumour is growing constantly, about 4% per year. In the central Europe the current incidence is approximately 14 cases per 100,000 inhabitants per year, in the USA it represents 10 to 25 cases and the highest incidence of 50-60 new cases is reported from Australia. The patient's prognosis depends on the tumour thickness and the early diagnostics is therefore essential for the favourable disease outcome. The accuracy of the melanoma clinical diagnostics has been enhanced by introduction of dermoscopy, particularly by its digital form. For the trained dermatologist it improves the accuracy of the clinical decision from usual 70 to more than 95%. The malignant melanoma mortality rate remains constant since the eighties of the 20th century. Exploration of new substances which should be able to prolong the patient's survival in metastatic stage is therefore in progress.