Head and neck melanoma.

Wide local excision is the mainstay in the treatment of the primary lesion with consideration given to specific anatomic constraints in head and neck melanoma. Sentinel lymph node biopsy is considered in all lesions with ulceration, mitoses greater than or equal to 1/mm(2), stage1B or higher, and in all high-risk nonmetastatic melanoma. Reconstructive strategy must be considered in multidisciplinary teams with reconstructive surgeons for large head and neck defects.