Skin Check Recommendations for Individuals with Family History of Melanoma
Individuals with a family history of melanoma should be referred to a dermatologist for regular total skin examinations, with frequency determined by the number of affected family members. 1
Risk Assessment and Referral Guidelines
High-Risk Criteria:
- Family history of three or more cases of melanoma: Referral to clinical geneticist or specialized dermatology services is strongly recommended 1
- Family history of two cases of melanoma: Referral should be considered, especially if one of the cases had multiple primary melanomas or atypical mole syndrome 1
Screening Recommendations Based on Risk:
For Individuals with Family History of Melanoma:
- Regular total skin examination by a dermatologist 1
- Monthly skin self-examinations 1
- Education on skin cancer prevention and sun protection measures 1
Surveillance Protocol
Self-Examination Component:
- Teach patients the ABCDE criteria for melanoma detection (Asymmetry, irregular Borders, Color variation, Diameter >6mm, Evolution over time) 2
- Instruct on monthly self-examination of skin and lymph nodes 1
- Provide written information and access to images of moles and melanomas for comparison 1
Professional Examination Component:
- Total cutaneous examination by a dermatologist at least annually 1
- Consider use of total cutaneous photography and dermoscopy for improved detection 3
- Close-up and distant photography may be useful adjuncts for detecting early melanoma 1
Importance of Early Detection
Research demonstrates that patients with high-risk factors who undergo regular skin examinations have melanomas detected at earlier stages:
- A study of high-risk patients followed with total cutaneous examinations and photography showed no melanomas ≥1mm in thickness developed during follow-up 3
- Early detection significantly improves survival rates, with 5-year survival for localized melanoma at 93.3% versus only 29.8% for stage IV disease 4
Common Pitfalls to Avoid
- Inadequate frequency of self-examination: About one-third of genetically predisposed individuals do not perform skin self-examinations at adequate frequency 5
- Overreliance on self-detection in older patients: Patients aged 50+ are less likely to detect their own melanomas; dermatologist detection is significantly more important in this age group 6
- Neglecting sun protection education: Sun protection measures should be emphasized alongside surveillance recommendations 1, 4
By following these guidelines, individuals with a family history of melanoma can significantly reduce their risk of advanced disease through early detection and appropriate intervention.