Evaluation and treatment of the patient with early melanoma.

In summary, prospective studies within the last 10 years have made a significant impact on our understanding of the natural history of early melanoma. Surgeons can now excise the melanoma with narrower and more selective margins that preserve function and cosmetic appearance. Early melanomas are now, and will continue to be the most common presentation of this cutaneous malignancy. This reflects an enhanced awareness of the public and the medical community about the value of increased detection, and serious attempts at protection from intense ultra-violet light exposure. Current research is now focusing on the inherited forms of melanoma, the effects of ultra-violet light on melanocytes and the immune cells of the skin, and the molecular measurement of the abnormal cytogenetics seen in malignant melanocytes. These studies will allow physicians to detect a melanoma at an earlier and earlier time point in its natural history, and perhaps prevent or reverse the formation of melanoma early in life.