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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 (dermoscopy). 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.
Medically Reviewed by a Doctor on 6/24/2014
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