Cutaneous melanoma (CM) is potentially the most dangerous form of skin tumor and causes 90% of skin cancer mortality. A unique collaboration of multidisciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization of Research and Treatment of Cancer (EORTC) was formed to make recommendations on CM diagnosis and treatment, based on systematic literature reviews and the experts' experience. The diagnosis of melanoma can be made clinically and shall always be confirmed through dermatoscopy. If a melanoma is suspected, a histopathological examination is required. Sequential digital dermatoscopy and full-body photography can be used in risk persons to detect the development of melanomas at an earlier stage. Where available, confocal reflectance microscopy can improve clinical diagnosis in special cases. Melanoma shall be classified according to the 8th version of the AJCC classification. Thin melanomas up to 0.8 mm tumor thickness does not require further imaging diagnostics. From stage IB onwards, examinations with lymph node sonography are recommended, but no further imaging examinations. From stage IIC whole-body examinations with CT or PET-CT in combination with brain MRI are recommended. From stage III and higher, mutation testing is recommended, particularly for BRAF V600 mutation. It is important to provide a structured follow-up to detect relapses and secondary primary melanomas as early as possible. There is no evidence to support the frequency and extent of examinations. A stage-based follow-up scheme is proposed, which, according to the experience of the guideline group, covers the minimum requirements; further studies may be considered. This guideline is valid until the end of 2021.

1st Department of Dermatology Aristotle University Thessaloniki Greece

1st Department of Dermatology University of Athens School of Medicine Andreas Sygros Hospital Athens Greece

APHP Department of Dermatology INSERM U976 University Paris 7 Diderot Saint Louis University Hospital Paris France

Center for Dermatooncology Department of Dermatology Eberhard Karls University Tuebingen Germany

Center for Dermatooncology Department of Dermatology Eberhard Karls University Tuebingen Germany; Portuguese Air Force Health Care Direction Lisbon Portugal

Department of Dermatology and Venereology Centro Hospitalar Universitário de Coimbra Coimbra Portugal

Department of Dermatology Erasme Hospital Université Libre de Bruxelles Brussels Belgium

Department of Dermatology Medical University of Vienna Austria

Department of Dermatology University Hospital Schleswig Holstein Campus Kiel Kiel Germany

Department of Dermatology University of L'Aquila Italy

Department of Dermatology Venerology and Allergology Frankfurt University Hospital Frankfurt Germany

Department of Dermatovenerology 3rd Faculty of Medicine Charles University of Prague Prague Czech Republic

Department of Oncology Odense University Hospital Denmark

Dermatology Clinic Maggiore Hospital University of Trieste Trieste Italy

Dermatology Department CHU Nantes CIC 1413 CRCINA University Nantes Nantes France

Dermatology Unit University of Modena and Reggio Emilia Modena Italy

Institute of Dermatology Università Cattolica Rome Italy; Fondazione Policlinico Universitario A Gemelli IRCCS Rome Italy

Medical and Surgical Dermatology Service Hospital Universitario Virgen Macarena Sevilla Spain

Melanoma Unit Department of Dermatology Hospital Clinic IDIBAPS Barcelona Spain

NIHR Biomedical Research Center University of Oxford UK

Princess Máxima Center 3584 CS Utrecht the Netherlands

Twin Research and Genetic Epidemiology Unit School of Basic and Medical Biosciences King's College London London SE1 7EH UK

University Department of Dermatology Marseille France

University Department of Dermatology Université de Versailles Saint Quentin en Yvelines APHP Boulogne France

References provided by Crossref.org

Patients with three or more primary melanomas: clinical-epidemiological study