Moderator: Dr Stephen Chege
Date: 14^th May 2026
SPEAKERS: Dr. Hannah Wanyika, Dr. Esther Gathura, Dr. Angela McLigeyo

This session examined melanoma care across the clinical pathway, from recognition of suspicious skin lesions to biopsy, excision, reconstruction, staging and systemic treatment.

A central theme was the importance of early suspicion and timely tissue diagnosis. Dr. Hannah Wanyika highlighted practical indications for biopsy, including new or changing pigmented lesions, non-healing ulcers, evolving moles and lesions that differ from surrounding skin. The discussion reinforced the use of the ABCDE approach and the “ugly duckling” sign, while emphasizing that changing lesions on the palms, soles, nails and scalp should not be dismissed.

Dr. Esther Gathura explored the surgical and reconstructive dimensions of melanoma care, particularly the realities of acral melanoma, which is common in African populations and often presents late. She emphasized the role of mapping biopsies, Breslow thickness, ulceration, nodal assessment and multidisciplinary planning in balancing oncologic safety with function, especially for weight-bearing areas of the foot.

Dr. Angela McLigeyo outlined the major advances in systemic therapy for advanced melanoma, including immune checkpoint inhibitors, targeted therapy and emerging treatment strategies. While immunotherapy has transformed outcomes globally, the session also acknowledged access, affordability and the urgent need for local data to guide treatment decisions in Kenya and the region.

Across the session, a consistent message emerged: optimal melanoma care depends on early recognition, accurate biopsy, careful staging, function-preserving surgery and realistic access to effective systemic therapy.

Key Takeaways

• Changing pigmented lesions, non-healing ulcers and suspicious nail or acral lesions require timely biopsy.
• The ABCDE rule and “ugly duckling” sign remain useful tools in clinical assessment.
• Acral melanoma presents distinct diagnostic and surgical challenges in African settings.
• Surgical management must balance clear margins, staging and functional reconstruction.
• Immunotherapy and targeted treatment have changed advanced melanoma care, but access and local evidence remain key challenges.