Melanoma of the nose

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Abstract
Background: Melanoma of the nose is rare and management guidelines are poorly defined. In the past, excision margins have often been much narrower than for melanoma elsewhere. Methods: The study was a retrospective clinicopathological study of 34 patients with cutaneous melanoma of the nose treated in a single unit. Results: Desmoplastic neurotropic melanoma and lentigo maligna melanoma were the most common histological tumour types. Local recurrence occurred in eight patients, and in six cases appeared to be a result of inadequate excision margins. Regional lymph node metastases were associated with a very poor prognosis. Conclusion: Adequate surgical excision is the mainstay of successful treatment for melanoma of the nose. Excision margins for nasal melanoma should not be any less than for melanoma elsewhere. Careful planning is required, not only to gain local disease control and the best chance of cure, but also to achieve functionally and aesthetically acceptable results. Excision margins need not be compromised in view of the variety of local flaps that can be employed to close the primary defect.

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