Cutaneous Melanoma of the Head and Neck: Contemporary Perspectives on Diagnosis and Management.

Abstract

<p><strong>Introduction:</strong> Cutaneous melanoma of the head and neck represents a distinct subtype of cutaneous melanoma with unique epidemiological, biological, diagnostic, and therapeutic characteristics. Although it accounts for approximately one-fifth of all cutaneous melanoma cases, it occurs more frequently in older individuals, more often arises in chronically sun-exposed skin, and is associated with a worse prognosis than melanomas at other anatomical sites. This review presents current knowledge on the epidemiology, aetiology, clinical presentation, diagnosis, and treatment of cutaneous melanoma of the head and neck, with particular emphasis on the specific features of this location.</p><p><strong>Aim:</strong> The aim of this study was to present current diagnostic and treatment strategies for cutaneous melanoma of the head and neck, with particular emphasis on the unique features of this anatomical location.</p><p><strong>Methods:</strong> This article is a narrative review informed by a structured literature search. The search was conducted in PubMed/MEDLINE, Scopus, and Web of Science, covering publications from January 2014 to March 2026.</p><p><strong>Results:</strong> Chronic ultraviolet radiation exposure remains the main aetiological factor, acting in conjunction with genetic predisposition and host phenotypic traits. The clinical presentation is diverse and includes both classic pigmented lesions and nodular, amelanotic, and lentigo maligna subtypes, with the latter being particularly common in chronically sun-damaged skin. Diagnosis requires an integrated approach involving clinical examination, dermoscopy, appropriately planned biopsy, and histopathological assessment, with selected cases also benefiting from non-invasive techniques, imaging studies, molecular diagnostics, and artificial intelligence-based tools. Sentinel lymph node biopsy remains a key component of regional staging. Surgical excision is the cornerstone of local treatment, although resection margins in this region often need to be individualised because of functional and aesthetic considerations. In recent years, systemic treatment, especially immunotherapy and targeted therapy, has gained major importance and has significantly improved outcomes in both the adjuvant and advanced disease settings.</p><p><strong>Conclusions:</strong> Cutaneous melanoma of the head and neck requires multidisciplinary and individualised management, and improved prognosis depends on early diagnosis, accurate staging, and the appropriate use of modern therapeutic strategies.</p>.