Clinical Differential Diagnosis of Cutaneous Malignant Melanoma
The clinical differential diagnosis of malignant melanoma has to be approached at three levels. At the most advanced level, the expert must be aware of a wide range of possibilities and must make a reasoned judgement as to what procedures are necessary to confirm his clinical impression, and thereafter institute appropriate therapy. At the level of general practice, the family doctor him or herself, should be aware of a reasonable range of diagnostic possibilities and be aware of clinical features which can help in assessment. The most obvious example here is that most family doctors should be able to distinguish between seborrhoeic keratoses or basal cell papillomas and melanocytic lesions. The third level is recognition of pigmented lesions which may have serious significance on the part of the patient. At this level it is important not to expect more than can be reasonably required of the general public. It is generally agreed that the most consistent feature of an early malignant melanoma is change. This is sensitive but is not specific, but if the public are advised that any new or changing pigmented lesions in an adult should be shown to their medical adviser, in general, tragedies will be avoided.
KeywordsPigment Lesion Superficial Spreading Melanocytic Lesion Nodular Melanoma Clinical Differential Diagnosis
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