Only the diagnosis of melanoma in situ (early stage of melanoma) and melanomas of low thickness (measured by the Breslow index) could reduce mortality related to this cancer.

The patient’s prognosis depends on the value of the Breslow index.

The stage of severity of melanoma cannot be known solely from the clinical aspect.

Criterion E of the ABCDE rule is the most relevant criterion.

The identification of melanoma by clinical examination remains difficult for small melanomas (< 6 mm) and for nodular forms that do not fall within the scope of the ABCDE rule.

Questioning and Clinical Examination

Patient advice

Primary prevention consists of information on sun exposure:

Caution with regard to the sun in the middle of the day (60% of the ultraviolet (UV) dose is received between 12 and 4 p.m.),
Favor clothing and behavioral protection,
use sun protection products as a last line of protection (UVB index above 15, extended as much as possible in the UVA spectrum) and above all not as an excuse to increase the duration of exposure,
Limit the use of tanning lamps.

2) Self-examination allows the patient to examine the entire skin on their own (completion time: 15 minutes). Your patient will need to look for a lesion that is clinically different from their other nevi or of recent onset or progressive in size, color, or thickness.

-Step 1: Direct examination: the patient will have to examine with the naked eye the palms of his hands and feet, his nails, his fingers and the spaces between the fingers of the hands and feet, the front of his arms and forearms, his thighs and legs.

-Step 2: The full-length mirror examination: the patient will have to stand in front of a vertical footed mirror and examine his skin from top to bottom. He will turn the left and then the right side of his body towards the mirror, with his arms raised vertically.

-Step 3: Examination with a hand mirror: for areas of skin that are not accessible to the eye, the patient can use a hand mirror. Sitting on a stool, he raises each leg to examine the internal, external and posterior aspects of the calf and thigh. The posterior aspect of the arms, neck, back, scalp and genital area will also be examined using the hand mirror. The patient can also ask for help from someone close to him