Paediatric melanoma : challenges in diagnosis and management

Paediatric melanoma, although relatively rare, is the most common cutaneous malignant tumour of childhood. It is often not suspected at initial presentation. It may be misdiagnosed due to poor correlation of conventional ABCDE criteria and ambiguous histopathological features. This younger patient group is more likely to have thicker tumours and positive sentinel lymph node biopsy compared with adult melanoma patients at diagnosis. Despite this, melanoma-specific death rates are lower than those in adults. This suggests different biological behaviour of paediatric compared to adult melanomas. Significant psychosocial issues may exist in the patient and their family. These may delay diagnosis and affect the compliance with management and so should be closely monitored, and intervention arranged if warranted.