After having removed the melanoma and having carried out all the procedures described in the previous sections (sentinel node, wound enlargement, medical therapy or radiotherapy) the patient must be followed closely by a dermatologist who must monitor the patient’s skin in order to identify any local or distant recurrences on the skin, a dermatological visit with dermatoscopy is therefore necessary every 6 months (the visit can be short-term if the patient notices abnormal lesions on the skin or if there is a family history of melanoma or if the patient has numerous dysplastic nevi) .
Blood tests will also be prescribed such as blood count, ESR, PCR, transaminases, creatinine, LDH. In thin melanomas, a chest x-ray and an abdominal ultrasound can also be recommended every 6 months. In high-risk melanomas it is necessary to perform a total body MRI or CAT scan or PET. In all ways, instrumental examinations must be performed for 5 years. It is necessary for patients to implement a healthy lifestyle and to protect themselves effectively from solar radiation. Finally, relatives of patients with melanoma must undergo periodic dermatological checks. Cases of relapses even after 10 years have been described, so careful monitoring is advisable even after 5 years.
Follow up according to staging
- Stage 0/IA: six-monthly dermatological visit, no checks, unless there are specific symptoms that cannot be explained in any other way
- Stage IB and IIB: dermatological visit every 4 months for 5 years, LDH and blood tests, chest X-ray, abdominal ultrasound and lymph node stations every 6 months for at least 5 years
- Stage IIC and III: Dermatological visit every 4 months for 5 years, LDH and blood tests, chest X-ray, abdominal ultrasound and lymph node stations every 6 months for at least 5 years, CT or total body PET every 6 months
- Stage IV: biopsy of suspected metastasis, dermatological visit every 4 months for 5 years, LDH and blood tests, chest X-ray, abdominal ultrasound and lymph node stations every 6 months for at least 5 years, CT or total body PET every 6 months
