Melanoma

Abstract

IntroductionMelanoma is a malignant tumour starting in the melanocytes that is located at skin level in 95% of cases. Despite its high incidence, mortality has stabilised in recent years thanks to early detection campaigns, prompt surgery and improved survival with new treatments in the metastatic stage. EpidemiologyThe risk of developing a melanoma is directly associated with exposure to the sun. However, personal factors also have an impact, such as skin type, epidemiological factors, precursor lesions, and genetic aspects. DiagnosisAlthough to date, many prognostic factors for melanoma have been identified, the only predictor for treatment response is the presence of BRAF V600E mutation in the DNA of the tumour cells, which it is compulsory to determine in all cases of metastatic melanoma. TreatmentLocal melanoma should always be surgically removed with wide margins, and formal regional lymphadenectomy in cases of clinical lymph node involvement, or selective biopsy of the sentinel gland in the presence of tumour cells in patients with no previous suspicion of lymph node involvement. Metastatic melanoma should be treated systemically, based on the three essential pillars: immunotherapy, BRAF inhibitors and chemotherapy.