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October 15, 1973

Total Excision Biopsy for Primary Malignant Melanoma

Author Affiliations

New York University Medical Center

JAMA. 1973;226(3):354-355. doi:10.1001/jama.1973.03230030066028

To the Editor.—  There are few areas where a biopsy is more important or more readily performed than for lesions of the skin. Definitive therapy depends upon a correct diagnosis obtained by means of an adequate and representative biopsy sample.Any pigmented skin lesion that shows unexpected change should be regarded as a possible melanoma until proved otherwise. The unpigmented melanoma may be disarming in appearance and look much like granulation tissue or a pyogenic granuloma. Suspicion of melanoma should be aroused when a pigmented lesion increases in size, changes in color, exhibits pain, irritation or pruritus, becomes infected, bleeds, ulcerates, or becomes crusted. These changes are particularly common in light-skinned, freckled, blue-eyed individuals, but by no means is melanoma limited to this group.If the diagnosis of melanoma is suspected, it should be established, when possible, by total excision biopsy. Exceptions include lesions that are so large or so