Pigmented skin lesions in the elderly: considerations in the differential diagnosis

Malignant melanoma affects all age groups, but its highest age-specific incidence is in the elderly. Early diagnosis depends on the ability to identify potential precursor lesions and subtle changes in melanocytic nevi indicative of malignant degeneration. Familiarity with the clinical appearance of the common benign pigmented lesions is essential to minimize unnecessary biopsy procedures. Certain clues aid the differential diagnosis and enhance early recognition, which is presently the most effective means of reducing both the morbidity and mortality from this most ominous of skin cancers.