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Melanoma Management: When to refer to a Surgeon

  • If doing a punch biopsy of a larger pigmented lesion, use at least 5-6mm size punch size.

  • Surgical referral is warranted for anyone high risk thin melanoma (with ulceration, young age, intermediate/thick melanoma, clinical nodal disease, in transit-disease, and recurrence.

  • Gene expression profiling, combined with pathologic staging, is the future of melanoma management.