In the management of suspected melanoma, what is the next step?

In the management of suspected melanoma, the appropriate next step is an excisional biopsy. This procedure involves the surgical removal of the entire lesion along with a margin of surrounding tissue. The purpose of an excisional biopsy is twofold: it allows for definitive diagnosis through histopathological examination and it also removes the melanoma, which is crucial for treatment if the diagnosis is confirmed.

Melanoma is a potentially aggressive skin cancer, and early diagnosis and intervention are critical for improving patient outcomes. An excisional biopsy not only confirms the presence of melanoma but also helps determine the depth of invasion, which is important for staging the cancer and planning further treatment.

While other management options may be suitable in different contexts, they are not appropriate next steps in the case of a suspected melanoma. For instance, topical ointments may be used for superficial skin issues but are ineffective and inappropriate for malignant lesions. Fine needle aspiration is generally used for sampling fluid or tissue from masses but is not the gold standard for melanoma due to its inability to provide sufficient tissue for accurate diagnosis and treatment planning. Observation over time may be applicable in certain benign cases or stable lesions but is risky in suspected cases of melanoma, where timely intervention is crucial. Thus, excisional biopsy is the definitive next step when