Updated Melanoma Guidelines: What Dermatologists Need to Know

Source: Dermatology, June 2019

In the past decade, advances in the understanding of melanoma have led to new therapeutic options and treatment strategies. In response, late last year the American Academy of Dermatology (AAD) released updated guidelines on the management of primary cutaneous melanoma. The guidelines were last updated in 2011, and the new recommendations reflect changes made in the American Joint Committee on Cancer 8th edition for staging of cutaneous melanoma (Tables 1 and 2). They were developed based on the latest evidence in the field and address new areas of interest, including the management of melanoma among pregnant patients, considerations for genetic testing for hereditary risk, and managing cutaneous adverse events to novel immunotherapies and targeted agents.

he Dermatologist spoke with Susan M. Swetter, MD, chair of the work group that updated the guidelines and David Leffell, MD, about these changes and how they might impact practicing dermatologists. Dr Swetter is a professor of dermatology and director of the Pigmented Lesion and Melanoma Program and Cutaneous Oncology at Stanford University Medical Center and Cancer Institute in Stanford, California. Dr Leffell is the David Paige Smith Professor of dermatology and surgery and chief of the section of dermatologic surgery and cutaneous oncology in the department of dermatology at Yale School of Medicine in New Haven, Connecticut.

“For the 2018 melanoma guidelines, our multidisciplinary work group identified key questions that are frequently encountered in clinical practice, including melanoma in pregnancy and management of dermatologic toxicities related to novel systemic immunotherapies and targeted agents,” said Dr Swetter. “We hoped to provide guidance for practitioners and patients alike, based on the available worldwide evidence.”