A proper diagnosis is essential for selecting the best treatment. The diagnosis of skin melanoma can only be made with a biopsy, which is then examined under a microscope by a pathologist. Pathologists who specialize in looking at skin biopsies are called dermatopathologists, but even board-certified dermatopathologists may not have extensive expertise in recognizing melanoma in children. In addition, even expert dermatopathologists sometimes disagree about the classification of a child’s mole as benign, atypical or malignant. It is important to be sure that an expert dermatopathologist has looked at your child’s biopsy, and you especially need to know if there is some degree of uncertainty about whether the mole is benign, atypical or malignant. Sometimes, highly specialized diagnostic tests like FISH and CGH are used to better classify pediatric lesions.
Because pediatric melanoma is difficult to diagnose, the diagnosis can sometimes be delayed or misdiagnosed. Most doctors don’t expect it, and some types of pediatric melanoma look different than adult melanoma. Sometimes pediatric melanoma is misdiagnosed as pyogenic granulomas, atypical melanocytic neoplasms, warts or spitz nevi.
If the biopsy comes back as a melanoma, surgeons may perform another surgery to ensure there are clear margins – the term used for the complete removal of the lesion. Depending on the diagnosis, the doctor may recommend a sentinel lymph node mapping, and depending on those results, a lymph node resection may be performed. This will help the doctors know if the melanoma has spread beyond the primary tumor. All of this information will be included in pathology report. The pathology report will help you understand your child’s stage of diagnosis, as well as help guide your treatment options.
Melanoma does not discriminate – NEVER LET A DOCTOR TELL YOU THAT YOUR CHILD IS TOO YOUNG TO GET MELANOMA.
Learn more about melanoma and how it is staged.
What does pediatric melanoma look like?
Your child’s skin should be evaluated by a professional familiar with pediatric melanoma if you see any area with one of the following features:
- A bump that itches and bleeds
- A spot that looks like an unusual wart – sometimes non-pigmented or with a pinkish color
- An amelanotic lesion – a lump on the skin that isn’t dark or black (like many adult melanomas)
- A mole that becomes nodular – very bumpy and sticking out far from the rest of the skin
- A lesion that presents as a nodule, or lump, especially one that has been rapidly enlarging
- Moles that look strange or large – especially a mole that looks DIFFERENT from your child’s other moles or has more than one color
Although some research suggests that the ABCDEs of melanoma should be revised when using them for diagnosing melanoma in children, it is important to remember that in most cases, the E, for evolution or change, is the most important factor to consider.
READ THE BLOG: Beyond the ABCDs
What if I spot something suspicious?
Screening for melanoma starts at home. Parents should be aware of all moles that their children have so that they will notice any changes or new moles.
A dermatologist, preferably one who has a lot of experience in melanoma, should examine your child’s skin immediately. Alternatively, you may wish to have your child examined at a pediatric pigmented lesions clinic or by a pediatric oncologist experienced in pediatric melanoma. It is important that melanoma is detected as early as possible to ensure the best outcome.
Check out our Kid’s Guide to Self-Screening!
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Content last updated: May 20, 2020