皮肤恶性黑色素瘤占癌症诊断的 5%，是美国第五大常见癌症。皮肤恶性黑色素瘤的危险因素包括日晒紫外线、菲茨帕特里克 I 型或 II 型皮肤、发育不良痣病史、室内晒黑、年龄较大以及黑色素瘤个人或家族史。美国预防服务工作组建议对患者进行咨询，以尽量减少早期紫外线辐射暴露，包括使用防护服和防晒霜，特别是对于 6 个月至 24 岁的患者。帮助诊断皮肤恶性黑色素瘤和决定活检的工具包括 ABCDE 助记符、丑小鸭标志​​和皮肤镜检查。任何可疑的色素病变都应进行活检。优选采用深勺刮取、碟状切片、打孔活检或全层切除进行活检，以确保去除整个病变，从而获得 Breslow 深度的准确测量。 Breslow 深度对于分期、治疗考虑和预后很重要。由皮肤科医生或外科医生进行具有适当边缘的广泛局部切除是主要的治疗选择。 Breslow深度小于0.8mm的薄病灶通常在广泛局部切除后不需要进一步治疗，预后良好。 Breslow 深度大于 0.8 毫米的病变可能需要进一步的诊断测试或程序，包括前哨淋巴结活检、完整淋巴结清扫、基因突变分析以及可能的全身免疫疗法治疗。全身免疫疗法的使用改善了晚期黑色素瘤（III期和IV期）的预后，5年生存率分别为74.8%和35%，而免疫疗法出现之前1975年至2011年的5年生存率为62.6%和16%。

Cutaneous malignant melanoma accounts for 5% of cancer diagnoses and is the fifth most common cancer diagnosed in the United States. Risk factors for cutaneous malignant melanoma include ultraviolet radiation from sun exposure, Fitzpatrick skin type I or II, a history of dysplastic nevi, indoor tanning, older age, and a personal or family history of melanoma. The U.S. Preventive Services Task Force recommends counseling with patient education on minimizing early ultraviolet radiation exposure, including the use of protective clothing and sunscreen, especially for patients 6 months to 24 years of age. Tools to aid in the diagnosis of cutaneous malignant melanoma and the decision to biopsy include the ABCDE mnemonic, ugly duckling sign, and dermoscopy. Any suspicious pigmented lesion should be biopsied. Biopsy with a deep scoop shave, saucerization, punch biopsy, or full-thickness excision is preferred to ensure the entire lesion is removed to obtain an accurate measurement of Breslow depth. Breslow depth is important in staging, treatment consideration, and prognosis. Wide local excision by a dermatologist or surgeon with appropriate margins is the primary treatment of choice. Thin lesions with a Breslow depth of less than 0.8 mm usually do not need further treatment after wide local excision and have an excellent prognosis. Lesions with a Breslow depth greater than 0.8 mm may need further diagnostic tests or procedures, including sentinel lymph node biopsy, complete lymph node dissection, gene mutation analysis, and possible treatment with systemic immunotherapy. Use of systemic immunotherapies has improved the prognosis for advanced melanoma (stages III and IV), with 5-year survival rates of 74.8% and 35%, respectively, compared with 62.6% and 16% from 1975 to 2011 before immunotherapy was available.