Melanoma Detection & Treatment in Clovis & Fresno, CA
Melanoma is the most dangerous form of skin cancer — but it is also one of the most treatable when caught early. At Dehesa Dermatology, board-certified dermatologist and Mohs surgeon Dr. Luis A. Dehesa is specially trained in the early detection and comprehensive management of melanoma. With over 20 years of experience and expertise in surgical dermatology, Dr. Dehesa provides patients throughout Clovis, Fresno, and the Central Valley with the highest level of skin cancer care available in the region.
What Is Melanoma?
Melanoma is a malignant tumor that arises from melanocytes — the pigment-producing cells found in the skin, eyes, and other tissues. When melanocytes undergo genetic mutations, typically triggered by UV radiation damage from the sun or tanning beds, they can multiply uncontrollably and form a cancerous lesion. Unlike basal cell and squamous cell carcinomas, melanoma has a significantly higher potential to metastasize — spreading to lymph nodes and distant organs — if not detected and treated at an early stage.
Despite being less common than other skin cancers, melanoma accounts for the majority of skin cancer deaths. In the United States, approximately 100,000 new cases are diagnosed each year. Living in a high-UV region like Fresno and Clovis — where the sun is intense year-round — places residents at elevated risk. This makes regular dermatologic skin exams critically important for everyone in our community, particularly those with fair skin, a history of sunburns, or a personal or family history of skin cancer.
Recognizing Melanoma — The ABCDEs
The ABCDE rule is the standard framework for identifying suspicious moles or growths that warrant professional evaluation:
- A — Asymmetry: One half of the mole or lesion does not match the other half in shape.
- B — Border: The edges are irregular, ragged, notched, or blurred rather than smooth and well-defined.
- C — Color: The color is not uniform — shades of brown, black, tan, red, white, or blue may be present within the same lesion.
- D — Diameter: The lesion is larger than 6 millimeters (about the size of a pencil eraser), though melanomas can be smaller when first detected.
- E — Evolving: The mole or spot is changing in size, shape, color, or symptom (itching, bleeding, crusting) over weeks or months.
Any mole or spot that meets one or more of these criteria warrants prompt evaluation at Dehesa Dermatology. Call (559) 951-9000 to schedule a skin check. Learn more about our comprehensive mole evaluation and removal services and our broader skin cancer care.
Types of Melanoma
Melanoma presents in several distinct clinical forms, each with its own appearance, location, and behavior:
- Superficial Spreading Melanoma: The most common type, accounting for approximately 70% of cases. Grows horizontally along the surface of the skin before invading deeper layers. Often appears as a flat or slightly raised lesion with irregular borders and varied color.
- Nodular Melanoma: The most aggressive form, growing rapidly downward into the skin from the start. Typically appears as a raised, uniformly dark or even amelanotic (flesh-colored or pink) nodule. Requires urgent evaluation and treatment.
- Lentigo Maligna Melanoma: Develops within a lentigo maligna — a precancerous lesion that grows slowly on chronically sun-damaged skin, typically on the face of older patients. Appears as a large, flat, irregularly pigmented patch.
- Acral Lentiginous Melanoma: Occurs on the palms, soles, and beneath nails. Most common melanoma subtype in individuals with darker skin tones. Often missed or diagnosed late due to its unusual location.
- Amelanotic Melanoma: Lacks the typical pigmentation, appearing pink, red, or flesh-colored. Easily mistaken for a benign growth, making dermoscopic evaluation essential.
Melanoma Diagnosis and Staging
If a suspicious lesion is identified during your skin exam, Dr. Dehesa will perform an in-office biopsy to obtain tissue for pathological analysis. A biopsy is the only definitive way to diagnose melanoma. If melanoma is confirmed, the pathology report will include the Breslow thickness — the depth of invasion, which is the most important factor in determining prognosis and treatment strategy.
For thicker melanomas or those with other high-risk features, additional workup including sentinel lymph node biopsy, imaging, and oncology consultation may be recommended. Dr. Dehesa coordinates with oncologists and surgical specialists as needed to ensure comprehensive, coordinated care.
Melanoma Treatment
Treatment for melanoma depends on the stage and location of the tumor:
- Wide Local Excision: The primary treatment for localized melanoma. The tumor is surgically removed along with a margin of normal-appearing skin to ensure complete clearance. Margin widths are determined by the Breslow thickness of the melanoma.
- Mohs Micrographic Surgery: In select cases — particularly lentigo maligna melanoma on the face or in cosmetically sensitive areas — Mohs surgery offers the advantages of complete margin control and maximum tissue conservation. Dr. Dehesa is a fellowship-trained Mohs surgeon. Learn more on our Mohs surgery page.
- Immunotherapy: For advanced or metastatic melanoma, immunotherapy agents such as checkpoint inhibitors have dramatically improved survival outcomes and are coordinated through oncology.
- Targeted Therapy: Patients with specific BRAF or other oncogenic mutations may be candidates for targeted molecular therapies.
- Radiation Therapy: Used in select cases as adjuvant therapy or for regional lymph node control.
Melanoma Prevention and Regular Skin Checks
The two most effective steps you can take to protect yourself from melanoma are sun protection and regular skin exams. We recommend annual full-body skin checks for all adults — and more frequent monitoring for those with high-risk features such as a personal or family history of melanoma, numerous atypical moles, or a history of significant sun exposure or tanning bed use. At Dehesa Dermatology, we perform thorough full-body dermoscopic skin exams and digitally document suspicious lesions to monitor for change over time.
Frequently Asked Questions About Melanoma
What is the survival rate for melanoma?
When melanoma is detected at its earliest stage — while it remains confined to the top layer of the skin — the 5-year survival rate exceeds 98%. Survival rates decline significantly once melanoma spreads to the lymph nodes or distant organs. This is why early detection through regular skin exams is so critically important. If you notice a changing mole or suspicious spot, contact Dehesa Dermatology at (559) 951-9000 immediately rather than waiting.
Can melanoma appear anywhere on the body, not just in sun-exposed areas?
Yes. While UV radiation is the primary risk factor, melanoma can develop anywhere on the body where melanocytes are present — including areas that rarely or never receive sun exposure, such as the soles of the feet, palms, mucous membranes, and even the eye. This is particularly important to understand for patients with darker skin tones, who have a higher relative incidence of acral lentiginous melanoma occurring on non-sun-exposed sites.
How is melanoma different from a regular mole?
Regular moles are benign growths with smooth, even borders, uniform color, and a stable appearance that doesn’t change over time. Melanoma is distinguished by the ABCDEs: asymmetry, irregular borders, color variation, diameter greater than 6mm, and evolution or change over time. However, not all melanomas look like classic moles — some can appear as pink or flesh-colored nodules. When in doubt, have it checked at Dehesa Dermatology.
Is a biopsy painful?
Skin biopsies performed at Dehesa Dermatology are done under local anesthesia, making the procedure itself virtually painless. You may feel a brief pinch from the anesthetic injection, and mild soreness at the biopsy site for a few days afterward is normal. The discomfort is minimal compared to the importance of obtaining a definitive diagnosis. Results typically return within 7 to 10 business days.
What should I do if melanoma runs in my family?
A family history of melanoma is a significant risk factor that warrants proactive monitoring. We recommend that patients with first-degree relatives who have had melanoma begin annual full-body skin exams in their early adulthood and perform monthly self-exams at home. If you have multiple family members with melanoma, genetic counseling may also be recommended. At Dehesa Dermatology, we create individualized surveillance plans for high-risk patients.
Can tanning beds cause melanoma?
Yes — using a tanning bed before the age of 35 increases the risk of melanoma by approximately 75%. Tanning beds emit concentrated UVA radiation that penetrates deeply into the skin, directly damaging the DNA in melanocytes. No amount of tanning bed use is considered safe, and we strongly advise our patients in the Clovis and Fresno area to avoid artificial UV exposure entirely.
Does Dehesa Dermatology treat melanoma patients from Fresno?
Yes. Dr. Dehesa is one of the most experienced dermatologists and Mohs surgeons in the Clovis-Fresno area, and we regularly see patients from Fresno and throughout the Central Valley for melanoma screening, biopsy, and surgical treatment. Our office is located at 978 N Temperance Ave in Clovis, just a short drive from Fresno via Highway 168. Call (559) 951-9000 to schedule your skin cancer evaluation.