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Medical Author:

Gary W. Cole, MD, FAAD

Gary W. Cole, MD, FAAD

Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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The diagnosis of melanoma is suspected when a skin lesion exhibits some or all of the criteria described in the symptoms and signs section above. Melanomas may develop on any area of the skin, including the palms, soles, scalp, and under fingernails. Recently, handheld devices have been developed, utilizing magnification and polarized light, which can enhance the detection of dangerous pigmented lesions (epiluminescence microscopy). Suspicious lesions are surgically removed by the physician (a biopsy) in their entirety, if possible, and submitted to a pathologist who is an expert in the microscopic interpretation of skin disease. The diagnosis is made when the pathologist identifies certain microscopic features. Occasionally, certain lesions may not exhibit sufficient criteria to qualify as melanomas but may be "borderline" lesions. Then the pathologist may suggest that such worrisome lesions be re-excised with a margin of normal tissue surrounding the excision site.

If the diagnosis of melanoma is made, the pathologist will also describe its thickness in millimeters, how deep it has penetrated into the skin, if there is any invasion of nerves or blood vessels, and estimate its mitotic activity. These parameters can help the clinical doctor to decide on the next course of action.

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