Melanoma – Desmoplastic Melanoma

Desmoplastic Melanoma is a type of melanoma that I occasionally encounter in my The Woodlands dermatology and Conroe dermatology offices.  Clinically, a Desmoplastic Melanoma does not have the typical features seen in a classic melanoma as its histopathology differs in that it has a more scar like pattern, thus its clinical appearance may be that of a scar or skin colored nodule.  Desmoplastic Melanomas are most common in older men and are usually found on the head and neck.  The recurrence rate after wide excision of a Desmoplastic Melanoma is very high due to the predilection for perineural invasion in which the melanoma cells can reside in and travel along the cutaneous nerves.  In addition to wide excision of the cancer, Desmoplastic Melanomas are one of the only melanoma subtypes that necessitate adjuvant radiation treatment to prevent local recurrence.  As with all melanomas, lifelong surveillance by a board certified dermatologist is mandatory.