One of four types of cancerous moles or tumors of the skin.

Melanoma is the most serious skin cancer with its incidence rapidly increasing. It arises when melanocytes in the lower layer of the epidermis, that produce a dark protective pigment called melanin, become malignant. The main cause of skin cancer is overexposure to ultraviolet sunlight (UVL), especially when it results in sunburn and blistering. In addition to individuals with chronic sun exposure and sun-damaged skin, young adults and the elderly are affected most, though any age group is susceptible. Additional contributing factors related to skin cancers include: exposure to radiation; scarring from disease or burns; occupational exposure to chemical compounds; chronic inflammation; long-standing sores; and heredity. Most incidences of melanoma develop from existing pigmented moles. Melanoma occurs more commonly in Caucasians with fair complexions and rarely in dark-skinned individuals.

Although signs and symptoms of the condition include lesions usually found on the skin, lesions may occur on any epithelial surface, such as the gallbladder, esophagus, or upper respiratory tract. Lesions may appear asymmetric with irregular borders, and may have various colorations of tan, black, or brown. In the absence of melanin, lesions may be skin-colored, pink, red, white, or purple (amelanotic melanomas). Potential warning signs of the development of a melanoma lesion may include: a mole that changes size or surface appearance; scaliness; oozing; bleeding; itchiness; and tenderness or pain.

The face, ears, and scalp may be common sites for melanoma to occur. In men, lesions most commonly appear on the shoulders, back, chest, head, and neck. In women, the lower and upper extremities are the most common sites. When melanoma does occur in people with dark skin, common sites include under the fingernails, toenails, palms of the hands, or soles of the feet.

Physical examination and biopsy of large suspicious lesions for microscopic examination may be taken.

Treatment of melanoma may depend on the stage of disease, and age and general health of the individual. Treatments for melanoma may be used alone or in combination. The standard treatment is surgery. When melanoma has metastasized, chemotherapy may be implemented. Radiation therapy may be reserved for palliative treatment, as most melanomas are not radiosensitive. Immunotherapy (interferon) may be also be used as part of the treatment regime.

Regular skin cancer screening may be recommended for early detection and prevention. Early detection and treatment are essential while the condition affects the outermost skin layers for surgical removal to be successful. Additional preventive treatments may include avoiding sun exposure, wearing protective clothing, and use of sunscreen on exposed areas of the skin when sun exposure is unavoidable.

There is potential for melanoma to rapidly spread to distant sites in the body leading to destruction of other body tissues. Varying degrees and depth of scarring may result, depending on the extent of skin cancer.

May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% and/or other requirements/qualifications under 38 CFR 3.350 [Special monthly compensation ratings]. Also reference 38 CFR 3.155(d)(2).    

• If a skin malignancy requires therapy that is comparable to that used for systemic malignancies, i.e., systemic chemotherapy, X-ray therapy more extensive than to the skin, or surgery more extensive than wide local excision, a 100-percent evaluation will be assigned from the date of onset of treatment, and will continue, with a mandatory VA examination six months following the completion of such antineoplastic treatment, and change in evaluation based upon that or any subsequent examination will be subject to the provisions of 38 CFR 3.105(e). If there has been no local recurrence or metastasis, evaluation will then be made on residuals. If treatment is confined to the skin, the provisions for a 100-percent evaluation do not apply.