Strategies for early melanoma detection: Approaches to the patient with nevi

Given its propensity to metastasize and the lack of effective therapies for most patients with advanced disease, early detection of melanoma is a clinical imperative. Although there are no noninvasive techniques for the definitive diagnosis of melanoma, and the gold standard remains biopsy with histologic examination, a variety of modalities may facilitate early melanoma diagnosis and the detection of new and changing nevi. This article reviews the general clinical principles of early melanoma detection and various modalities that are currently available or on the horizon, providing the clinician with an LIP to date Understanding of management strategies for their patients with numerous or atypical nevi. (J Am Acad Dermatol 2009;60:719-35.)