Early detection is critical as advanced melanoma is very hard to treat. A thorough self-skin examination each month and visiting a dermatologist each year for a professional examination is recommended. It is important to examine all areas, including the toes, nail beds, palms and soles, genitals and even the eyes. If there is any suspicious lesion, a biopsy is the first step to diagnosis. Biopsy is to remove tissue from the skin and examined under a microscope by a specialist. If melanoma is determined in the biopsy and certain high-risk feathers were found, surrounding lymph nodes might be evaluated to determine whether any cells have traveled beyond the initial site. In addition, imaging studies with CT, MRI or PET CT will be utilized to determine whether there are any distant metastases. The extent of lymph node involvement and several other factors will help determine the stage of diagnosis.