What is the difference between melanoma and cutaneous carcinoma?

Melanoma arises from melanocytes (pigment-producing cells) and is the most serious form of skin cancer due to its high metastatic potential. Carcinomas (basal cell and squamous cell) arise from keratinocytes. Basal cell carcinomas are the most common skin cancers and have virtually no metastatic potential; squamous cell carcinomas can metastasise in approximately 5% of cases.

How do I recognise a suspicious melanoma?

The ABCDE rule helps detect suspicious lesions: A (Asymmetry), B (Border irregularity), C (Colour variation — several shades in the same lesion), D (Diameter greater than 6 mm), E (Evolution — any recent change). The presence of one or more of these criteria warrants prompt consultation with a dermatologist or surgeon.

Is skin cancer covered by French national health insurance?

Yes. Surgical excision of a melanoma or cutaneous carcinoma is fully covered by French national health insurance (Assurance Maladie). Melanoma may be recognised as a long-term condition (ALD) for advanced stages. All surgical management, pathological analysis, and follow-up is reimbursed.

Should I see a dermatologist or a plastic surgeon for skin cancer?

Both are complementary. The dermatologist often makes the initial diagnosis. The plastic surgeon performs surgical excision with immediate aesthetic reconstruction. For lesions on the face, neck, hands, or visible areas, a plastic surgeon is recommended to minimise scarring while ensuring oncological margins.

Can skin cancer be prevented?

Yes. The main cause of melanoma and carcinoma is UV exposure (sun and artificial UV). Sun protection (SPF 50+ on exposed areas, wearing a hat, avoiding peak sun hours) significantly reduces the risk. Annual mole checks with a dermatologist are recommended for at-risk individuals (fair skin, numerous nevi, family history).

Oncological dermatology — Complete guide

Skin Cancer

Melanoma & Carcinoma — Detection, surgery and follow-up

Skin cancer is the most common cancer in France. Melanoma, basal cell carcinoma, squamous cell carcinoma — each type has its own characteristics, but all benefit from early surgical management to maximise the chances of cure. Dr. de Clermont-Tonnerre performs excision and reconstruction in Paris 16th.

Important: Any mole that changes, bleeds, itches, or meets one of the ABCDE criteria should be seen promptly. A melanoma caught early is almost always cured by surgery alone.

The 3 main types of skin cancer

Most serious

Melanoma

Arises from melanocytes (pigment cells)
High metastatic potential
Diagnosed using the ABCDE rule
Treatment: wide excision + sentinel lymph node
Excellent prognosis if treated early

Most common

Basal cell carcinoma

Arises from basal keratinocytes
80% of skin cancers
Slow-growing, locally invasive
Virtually never metastatic
Treatment: excision with margins

Intermediate risk

Squamous cell carcinoma

Arises from suprabasal keratinocytes
Can metastasise (~5% of cases)
Often on aged or irradiated skin
Treatment: wide excision
Lymph node monitoring if needed

The ABCDE rule

How to monitor your moles yourself. One or more criteria present → seek urgent consultation.

Asymmetry

The two halves do not match

Border

Irregular, ragged or poorly defined edges

Colour

Multiple shades within the same lesion

Diameter

Larger than 6 mm (pencil eraser)

Evolution

Any recent change (size, colour, bleeding)

Surgical management in Paris

Prompt consultation

Clinical and dermoscopic examination. Assessment of the lesion. Scheduling of excision on an urgent basis if suspicious.

Diagnostic excision

Complete removal of the lesion with narrow margins under local anaesthesia. Pathology results in 5 to 7 days.

Wide re-excision (melanoma)

If melanoma is confirmed: wide excision according to tumour thickness (Breslow index). Sentinel lymph node biopsy if Breslow > 1 mm.

Reconstruction

Direct closure, local flap, or skin graft depending on size and location. Optimised aesthetic outcome.

Why a plastic surgeon?

For skin cancers of the face, neck, hands, and visible areas, the plastic surgeon brings unique expertise: respecting oncological margins while optimising the aesthetic result.

Dr. de Clermont-Tonnerre is proficient in all reconstruction techniques — direct suture, local flap, regional flap, graft — to achieve the best possible functional and aesthetic outcome.

All skin cancer excisions are covered by French national health insurance.

Frequently asked questions

Is melanoma always fatal?+

No. A melanoma diagnosed and treated at an early stage (in situ or stage I) is cured in nearly 100% of cases by surgery alone. The danger of melanoma lies in its metastatic potential, which depends primarily on tumour thickness at the time of diagnosis. This is why early detection is essential.

How long does it take to schedule a melanoma excision?+

Diagnostic excision (first removal) should be performed promptly, within 2 to 4 weeks of suspected diagnosis. If the result confirms melanoma, wide re-excision is scheduled within 4 to 6 weeks. Do not delay.

Can basal cell carcinoma recur?+

Yes. Basal cell carcinomas can recur locally, especially if excision margins are insufficient or in certain anatomical locations (nose, ears). This is why systematic pathological examination of every excised specimen is essential to confirm adequate margins.

Should I avoid sun exposure after skin cancer excision?+

Yes. Sun protection is paramount — first to protect the scar (risk of discolouration) but above all to prevent new skin cancers. Daily use of SPF 50+ sunscreen on exposed areas is recommended for life.