Published 4 September 2009, doi:10.1136/bmj.b3078
Cite this as: BMJ 2009;339:b3078

Practice

10-Minute Consultation

Malignant melanoma

Stella Ivaz, senior house officer—plastic surgery1, Hawys Lloyd-Hughes, senior house officer—plastic surgery1, Pippa Oakeshott, reader in general practice2, Saima Shah, senior teaching fellow in general practice2

1 Department of Plastic and Reconstructive Surgery, Charing Cross Hospital, Imperial College NHS Trust, London W6 8RF, 2 Community Health Sciences, St George’s, University of London, London SW17 0RE

Correspondence to: S Ivaz stellaivaz@hotmail.com

The first 150 words of the full text of this article appear below.

A 40 year old white woman is worried about a 5 x 7 mm brown and black lesion on her arm that has been getting darker over the past few months and has begun to itch. It has a regular border but is slightly raised. She has no axillary lymphadenopathy.

  • Is this a rapidly growing new mole or a long standing one that is changing in size, shape, colour, or sensation—for example, newly bleeding or itching?
  • What is the history of sun exposure? Ask about sunny holidays, occupational and recreational exposure, use of sun beds, and episodes of sunburn—particularly in childhood.
  • Photoprotection measures, for example, sunscreen use.
  • Personal history of malignant melanoma or other skin cancer.
  • Family history of malignant melanoma.
  • Immunosuppression.

Examine the mole and look for the ABCDE suspicious features (see box). Note whether the patient has sun sensitive skin (red or blonde hair, blue eyes, and particularly . . . [Full text of this article]


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