Here is what to expect when you schedule a visit to your doctor after detecting skin changes:

Complete Medical History

The doctor will first take a complete medical history to learn about your symptoms and risk factors. You will be asked your age, when you first discovered the area of concern on your skin, and if any features of that area have changed since your discovery. The doctor will ask about past exposures to known causes of skin cancer, such as sun exposure. You will also be asked whether you or your family have a history of atypical moles or skin cancer, particularly melanoma.

Complete Skin Examination

You will be asked to undress completely and be given a gown. The doctor will then perform a thorough and systematic examination of the skin, including scalp, nails, palms, soles, ears, and areas not exposed to the sun, including beneath the breasts or under any rolls of flesh. Suspicious moles and lesions will be evaluated with the naked eye for size, shape, texture, and any evidence of bleeding, oozing, or scaling. The doctor may use a handheld magnifying lens, or loupe, to more closely inspect areas of concern. You will also be checked for other spots and moles that may be related to skin cancer. With your permission, the doctor may take photographs of suspicious areas. These photos are often helpful as a reference for follow-up visits, to determine whether any changes have occurred.

New technique! - Dermoscopy (also referred to as epiluminescence microscopy) is a technique that enables physicians to view skin lesions down to the dermoepidermal junction, the site where melanomas usually develop and an area not visible to the naked eye.

How it's done: A drop of mineral oil is placed on the lesion to reduce light reflection and make the skin more translucent. The doctor then views the lesion through a dermoscope, a special handheld microscope that resembles the scope used in ear examinations. When used by a physician trained in the technique, dermoscopy increases the ability to distinguish accurately between suspicious and benign lesions.

Lymph Node Evaluation

The doctor will palpate (feel) the lymph nodes nearest the suspicious lesion, ( in the groin, or  underarm, or neck). If the nodes are enlarged or unusually firm, additional tests may be recommended to evaluate whether cancer has spread to the regional lymph nodes.

Skin Biopsy

A doctor who suspects that a skin spot is melanoma will perform a biopsy. In this procedure (usually performed with a local anesthetic to numb the area), the doctor removes the suspect lesion using techniques that preserve the entire lesion so that the thickness of the potential cancer and its margins (healthy tissue around the lesion that is removed to make sure no cancer cells remain) can be carefully examined. .

Pathology

Any skin samples taken by a biopsy or an excision are sent for microscopic examination, and a pathology report is issued by the pathologist (a doctor who specializes in interpreting and evaluating cells, tissues, and organs to diagnose disease). The pathology report  describes many aspects of the melanoma, including the type, the depth of invasion, the tissue level of invasion, the presence or absence of a lymphatic response, ulceration, regression, satellite lesions, and blood/nerve invasion.