The treatment of melanoma the surgical excision. A biopsy is first performed. If possible exercise the entire lesion with a 2 mm margin to a depth of at least 4 mm. Lesions in anatomically difficult areas are sampled by excision or punch biopsy of the thickest area. Shave biopsies are usually not adequate. Lesions with a classic presentation of melanoma may be treated definitively at the time of initial sampling. Remove the lesion with a 1 cm margin to a depth of at least 4 mm.
Sentinel node sampling is considered for melanomas thicker than 1 mm.
Lymph node dissection is performed with lymph node metastasis is confirmed by biopsy. There is no benefit of elective lymph node dissection when there is no evidence of nodal involvement.
Advanced disease is treated by surgical excision, chemotherapy, interferon and Ipilimumab. The prognosis for advanced disease is poor.