Cutaneous melanoma: An update on pathogenesis, prevention, and treatment

• Published in: Dermatological reviews Vol. 3; no. 6; pp. 384 - 399
• Main Authors: Frech, Fabio S., Bommareddy, Kanthi, Hernandez, Loren, Dreyfuss, Isabella, Urbonas, Rebecca, Nouri, Keyvan
• Format: Journal Article
• Language: English
• Published: 01-12-2022
• Subjects: genodermatoses; immunotherapy; melanoma; targeted therapy
• ISSN: 2637-7489; 2637-7489
• DOI: 10.1002/der2.153

Although the cause for the rise in melanoma incidence remains a topic of debate, its potentially aggressive nature necessitates a continual update on the pathophysiologic mechanisms of disease and current guidelines for management. Akin to other cutaneous malignancies, sun exposure remains a crucial risk factor in the development of different melanoma subtypes. There are specific non‐UV associated mutations that are commonly found in most melanomas and some nevi, such as B‐RAF V600E, that may represent an initial insult of a multistep process that eventually leads to progression of the lesion into a more aggressive phenotype. The standard of care for early melanoma management remains surgical excision with wide margins, however management changes with more advanced lesions by the addition of imaging, sentinel lymph node biopsies, genetic testing, immune, and targeted therapy. Different novel treatment regimens for advanced unresectable melanomas are being investigated with the use of targeted therapies and vaccines. Novel screening technology using artificial intelligence for detection of melanoma is currently being developed but remains in its early stages with its effectiveness being significantly lower compared to clinicians. As such, melanoma prevention and early detection through skin examinations remain crucial to avoid potentially deadly complications from more advanced lesions.