Treatment of Primary Melanoma

Patients with an atypical pigmented skin lesion or one which is suspected of malignancy must undergo removal with a narrow peripheral margin of 2 mm, including dermis down to the subcutaneous tissue. An incisional biopsy may be needed in aesthetic/functional areas or when dealing with particularly widespread primary lesions. Wide local excision after histological diagnosis is related to the characteristics of the primary lesion (Breslow’s depth) and requires removal of portions of healthy tissue surrounding the excised lesion in order to reduce any possibility of local cutaneous or subcutaneous recurrences. A reconstructive procedure may be necessary (skin graft, local flap, perforator flap, free flap). However, the simplest procedures and direct suture must be the priority whenever possible.