Licata G, Scharf C, Ronchi A, et al. - Scalp melanomas (SM) have a more aggressive nature as well as higher rates of recurrence and higher mortality than melanoma on other body sites. Including scalp examination in routine skin check is advisable for doctors and patients. Performing dermoscopy and reflectance confocal microscopy (RCM) can be beneficial.

• Analysis of literature data revealed high mortality rates associated with SM, with a 10-year survival rate of 60%.

• In cases with thin melanomas, findings show an atypical network or pseudo-network and regression in dermoscopy.

• Thick lesions most commonly display blue-white veil, irregular pigmented blotches and an unspecific pattern.

• RCM shows irregular meshwork in most cases, but also ringed and disarranged pattern have been described.

• Biopsy is advised for all suspicious lesions; thus, mostly the best option is an excisional biopsy with 2 mm margins.

• SM management is the same as for melanoma on other body sites.

• However, it is more challenging to perform sentinel node biopsy and achieve adequate excision margins of the primary tumor.