Dawaa Reference

chronic

Malignant Melanoma

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class SD25.02 - condition scope only, no dose · Metastatic Melanoma - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK470358/ · No dose - referral pathway, no medicine given in primary care

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (1)

  • A melanoma may itch, bleed, ulcerate, or develop nearby satellite lesions [itching · skin lesions]

Signs — what you find (6)

  • Asymmetric shape is one of the ABCDE melanoma warning signs
  • Irregular, ragged, notched, or blurred borders are a melanoma warning sign
  • Non-uniform or variegated color within the lesion is a melanoma warning sign
  • A lesion larger than 6 millimeters across is a melanoma warning sign
  • A change in size, shape, or color over time is a melanoma warning sign
  • An added F for family or personal history of melanoma is used when assessing nail-unit lesions

Tests (5)

  • Excisional biopsy is the preferred method to confirm and stage melanoma by depth of invasion
  • Incisional biopsy may be used instead for lesions under the nail, on palms or soles, or very large lesions
  • Bloodwork includes a full chemistry panel with alkaline phosphatase, liver enzymes, total protein, and albumin
  • Ultrasound may be the best imaging study to detect lymph node involvement
  • For finding metastatic spread, a PET-CT scan is likely the single best imaging option

If not this — what else fits (7)

  • Pigmented basal cell carcinoma
  • Blue nevus
  • Halo nevus
  • Dermatofibroma
  • Seborrheic keratosis
  • Lentigo is a differential diagnosis for malignant melanoma
  • Subungual hematoma

SourceStatPearls "Malignant Melanoma" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

An aggressive skin cancer arising from melanocytes, often within a pre-existing or new pigmented lesion; early recognition and prompt excision are critical since it can spread, so any suspicious pigmented lesion needs urgent dermatology/surgical referral rather than primary-care treatment. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

An aggressive skin cancer arising from melanocytes, often within a pre-existing or new pigmented lesion; early recognition and prompt excision are critical since it can spread, so any suspicious pigmented lesion needs urgent dermatology/surgical referral rather than primary-care treatment.

Cautions
  • RED FLAG - Subungual pigmentation (Hutchinson's sign) or amelanotic rapidly growing pink nodules: assess urgently and refer.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - Use the ABCDE criteria for a suspicious pigmented lesion - asymmetry, border irregularity, color variegation, diameter >6mm, evolving - as the recognition criteria for early melanoma.
  • RED FLAG - The additional alarm features of an existing pigmented lesion are itching, bleeding, ulceration, and satellite lesions.
  • RED FLAG - Asymmetry, an irregular border, colour variation, or an evolving change in a pigmented lesion (the ABCDE criteria), or a new pigmented lesion that bleeds, itches, or ulcerates, needs urgent referral.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.