Cutaneous melanoma (CM) remains the most dangerous form of skin tumor and accounts for 90% of skin cancer mortality. A unique collaboration of multidisciplinary experts made recommendations on CM diagnosis and treatment based on systematic literature reviews and the experts′ experience, which are as follows:

• Melanoma can be diagnosed clinically but must be confirmed with dermatoscopy.
• In suspicious cases of melanoma, a histopathological examination is always required.
• High-risk patients can undergo sequential digital dermatoscopy and full-body photography to improve the detection of early melanoma.
• Confocal reflectance microscopy can also improve clinical diagnosis in special cases, if available.
• Melanoma classification must follow the 8th version of the American Joint Committee on Cancer classification.
• Thin melanomas up to 0.8 mm tumor thickness does not require further imaging diagnostics.
• From stage IB onwards, recommendations are on using lymph node sonography, sparing further imaging examinations.
• From stage IIC onwards, the recommendation is to use whole-body examinations with computed tomography (CT) or positron emission tomography CT (PET-CT) in combination with brain magnetic resonance imaging.
• From stage III and higher, recommendations are on mutation testing, particularly for BRAF V600 mutation.
• Providing a structured follow-up to detect relapses and secondary primary melanomas as early as possible is crucial.
• No evidence defines the frequency and extent of examinations. 

The guidelines also propose a stage-based follow-up scheme, which covers the optimal requirements; however, further studies are needed. 

This guideline is valid until the end of 2024.

Source: Garbe C, Amaral T, Peris K, et al; European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC). European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics: Update 2022. Eur J Cancer. 2022;170:236-55.