Japanese Dermatological Association Guidelines: Clinical Questions of Guidelines for Melanoma 2025

Advancements in melanoma management have underscored the need for periodic guideline updates every few years to reflect current clinical practices. Previous versions of melanoma clinical practice guidelines in Japan have primarily aimed to reflect global standards of care. This focus on international benchmarks was largely attributed to the scarcity of high-quality evidence from East Asia, necessitating reliance on Western references. Recent findings indicate differences in melanoma subtypes and drug efficacy between Western and East Asian populations. Therefore, efforts were made to incorporate data from East Asia in this revision, aiming to develop guidelines that better reflect the region's unique characteristics. This revision was commissioned by the Japanese Dermatological Association (JDA) and Japanese Skin Cancer Society (JSCS) and was undertaken by a committee comprising experts across relevant fields who meticulously reviewed and systematized a wide range of literature on melanoma to develop comprehensive, evidence-based guidelines. Literature searches were conducted by the Japan Medical Library Association. The recommendation statements were determined using the GRADE Grid approach. The guideline was developed in accordance with the Minds Clinical Practice Guideline Creation Manual 2020, ver. 3.0. Twelve clinical questions (CQs) were established, and corresponding recommendation statements were provided for each CQ. For several CQs, the inclusion of data from East Asia resulted in recommendations that differed from those in Western guidelines. Considering that the biology of melanoma has been increasingly recognized to vary by subtype and ethnicity, guidelines should be developed independently for each region based on evidence specific to the melanoma characteristics of that region. We firmly believe that this Japanese clinical guideline for melanoma will contribute to improving melanoma management in East Asia.