# Ulceration (melanoma)

Source: https://onco.cc/terms/ulceration-melanoma/  
OnCo record `ulceration-melanoma` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Loss of the skin surface over a melanoma under the microscope; a sign of aggressive biology that raises the stage.

## Summary

Ulceration in melanoma is loss of the intact skin surface over the primary tumour as seen under the microscope, and it is a marker of aggressive biology. It is present in roughly a quarter of primary melanomas, independently worsens prognosis, and defines the b substage at each T level, so a lesion of a given Breslow thickness is staged higher if it is ulcerated. Historically it was taken to predict benefit from interferon; today its main role is in defining stage IIB and IIC, the group for which adjuvant PD-1 therapy is approved. The term is read alongside Breslow thickness, the other pathological feature that drives staging of the primary.

## Fields

- Kind: Term
- Last checked: 2026-09-07

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Melanoma
- NCI Dictionary of Cancer Terms: ulceration: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/ulceration
- Gershenwald et al., Melanoma staging: evidence-based changes in the AJCC eighth edition (CA: A Cancer Journal for Clinicians 2017): https://doi.org/10.3322/caac.21409

## Connected records

- cancers: [Acral melanoma](https://onco.cc/cancers/acral-melanoma/), [Melanoma](https://onco.cc/cancers/melanoma/), [Stage IIB and IIC melanoma](https://onco.cc/cancers/stage-ii-melanoma/), [Stage III melanoma (after surgery)](https://onco.cc/cancers/stage-iii-melanoma/)
- terms: [Breslow thickness](https://onco.cc/terms/breslow-thickness/)

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JSON: https://onco.cc/api/v1/entities/ulceration-melanoma.json