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BASICS IN DERMATOLOGIC SURGERY
Melanoma on the upper extremities can appear as a new or changing mole, and its presentation can vary, with some cases being aggressive and others more indolent. Diagnosis often involves a physical exam and imaging, with treatment typically beginning with surgical removal. Follow-up care is crucial to monitor for recurrence or metastasis.

Diagnosis
Appearance: Can look like a raised lump or a flat, dark spot, and may be pink, red, or brown, with or without color.
Symptoms: May be painful or itchy, bleeding, or crusty. A dark spot under a fingernail that isn’t due to injury can also be a symptom.
Evaluation: A dermatologist will examine the affected area and may use imaging techniques like MRI, CT, or PET scans to stage the melanoma.
Treatment
Surgery: The primary treatment is surgery to remove the cancerous lesion.
Here the first surgical session presented.
Narrow surgical security margin as the AJCC / EJC recommended was performed.