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 has a history of atypical moles or skin cancer, particularly melanoma.

Physical Examination

• Complete skin examination. You will be asked to undress completely. 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 hand-held 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.
• Dermoscopy (also referred to as epiluminescence microscopy) is a new technique that enables physicians to view skin lesions down to the dermo-epidermal junction, the site where melanomas usually develop and an area not visible to the naked eye. 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 hand-held 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 moles and other pigmented lesions.
• Lymph node examination. The doctor will palpate (feel) lymph nodes in the groin, underarm, and neck near the suspicious lesion. If the nodes are enlarged or unusually firm, additional tests may be recommended to evaluate whether cancer has spread to the regional lymph nodes.
• A chest x-ray is taken to make sure melanoma has not spread to the lungs, the lymph nodes in the mediastinum (space in the chest between the lungs), or the bones of the rib cage.
• A CT scan of the chest, head, abdomen, or pelvis may be recommended if distant metastases are suspected. A rotating x-ray beam takes a series of pictures of the body from many angles. A computer combines the information from all the pictures and makes a detailed, cross-sectional image of the body. If you imagine the body as a loaf of bread, each image is a slice of the loaf. Radiation exposure from a CT scan is higher than that of a conventional x-ray, but is still minimal and should produce no effects. Contrast agents or dyes are often used in CT exams. They highlight certain tissues in the body that may otherwise be hard to see.
• Magnetic resonance imaging (MRI) may be recommended in place of a CT scan. The only difference is that the cross-sectional images of the body are created by magnetic fields instead of x-rays.
• Serum lactate dehydrogenase (LDH) is an enzyme found in the blood and many body tissues such as the liver, kidney, brain, and lungs. Elevated levels of LDH may indicate the presence of metastatic disease. LDH levels are determined by a simple blood test.