Is Clark level still used in melanoma staging?

Clark level was removed from AJCC 8th edition primary tumor staging but is still reported histologically. It had value for thin melanomas (Breslow <=1mm) but was superseded by ulceration and mitotic rate as better prognosticators.

What Clark level is clinically important?

Clark IV (reticular dermis) and V (subcutaneous fat) were historically important for T1b classification. Now Breslow depth (0.8mm threshold with ulceration) is the primary staging criterion.

How does Clark level relate to lymphatic invasion risk?

Dermal lymphatics begin at the papillary-reticular junction (Clark III-IV). Invasion into reticular dermis (Clark IV+) correlates with lymphatic involvement risk, which is why Breslow >0.8mm triggers SLNB consideration.

Clark Level Dermis Invasion

Assess melanoma anatomical invasion level using Clark classification: Level I (epidermis), II (papillary dermis), III (papillary-reticular junction), IV (reticular dermis), V (subcutaneous fat).

⚕ Clinical Disclaimer: These calculators are for educational and reference purposes only. Always verify results with qualified clinical judgment and current clinical guidelines. Do not use as a sole basis for medical decisions.

How It Works

Assess melanoma anatomical invasion level using Clark classification: Level I (epidermis), II (papillary dermis), III (papillary-reticular junction), IV (reticular dermis), V (subcutaneous fat)

Each component has a specific meaning:

Clark classification: Level I — The clark classification: level i recorded for the scenario being assessed.
II — The ii recorded for the scenario being assessed.
III — The iii recorded for the scenario being assessed.
IV — The iv recorded for the scenario being assessed.
V — The v recorded for the scenario being assessed.

Note: Interpret the clark level result against the thresholds and context described above.

How to Use

Enter the Clark classification: Level I, II, III, IV, V for the scenario you are assessing. Assess melanoma anatomical invasion level using Clark classification: Level I (epidermis), II (papillary dermis), III (papillary-reticular junction), IV (reticular dermis), V (subcutaneous fat). Use the clark level result to inform your calculation.

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