Based on WHO | Is fever a symptom of melanoma?

Fever is not a typical early symptom of melanoma on the skin, but it can occur in certain situations, especially with advanced disease or as a side effect of specific melanoma treatments. Melanoma most often first shows up as a changing spot on the skin not as systemic symptoms like fever. ^[1] As melanoma progresses or spreads, other systemic symptoms can appear, and some treatments commonly used for melanoma can cause fever. ^{[2] [3]}

What early melanoma usually looks like

The most common early signs are changes in a skin spot or mole: asymmetry, irregular borders, uneven color, increasing size, or evolution over time. A new or changing spot is far more typical than fever in the early stage. ^[1] Early detection relies on noticing skin changes rather than general body symptoms.

When fever can be related to melanoma

• Advanced or metastatic melanoma: As melanoma spreads, broader body symptoms can occur, such as fatigue, weight loss, and malaise; fever can be part of these nonspecific cancer-related symptoms. Systemic symptoms like fever can occur, particularly with widespread disease, though they are not specific to melanoma. ^{[2] [3]}
• Paraneoplastic (tumor-related) fever: Some cancers can trigger fever without infection, sometimes called “neoplastic fever” or “paraneoplastic fever.” In malignancies, fever may occur without proven infection and needs careful evaluation to distinguish tumor-related fever from infection. ^[4]
• Immune-related or inflammatory syndromes: Rarely, melanoma can be associated with neutrophilic dermatoses like Sweet’s syndrome, which presents with high fever and rash. These are uncommon, but they illustrate that fever can accompany melanoma through immune-mediated pathways. ^{[5] [6]}

Fever as a side effect of melanoma therapies

Several modern melanoma treatments commonly cause non-infectious fever:

• BRAF and MEK inhibitors (e.g., dabrafenib + trametinib, encorafenib + binimetinib): Non-infectious febrile events are common, often starting within weeks, and can include chills, dizziness, fatigue, and hypotension. ^[7] Patients are typically advised to pause therapy at the onset of fever symptoms and notify their care team for early management. Education on recognizing “fever syndrome” and temporarily stopping medication is a key part of safe use. ^[8]
• Vemurafenib: A temperature of 38°C (100.4°F) or higher, with associated chills or sweats, warrants urgent medical contact during treatment. ^[9]

These drug-related fevers are frequent and often non-infectious, but infection must still be ruled out, especially if symptoms are severe or persistent. Management can include temporary interruption of the drug, hydration, antipyretics, and sometimes short courses of steroids. ^{[7] [10]}

Practical guidance if you have fever and melanoma

• If you are not on melanoma therapy and develop unexplained fever, it may be due to common causes like viral infections, but it can occasionally be related to cancer; evaluating for infection is essential. Fever without a clear source should be assessed, and in cancer, infections must be considered first. ^[4]
• If you are on targeted therapy (BRAF/MEK inhibitors) or certain immunotherapies, fever is a known side effect, and your care team may advise specific steps such as pausing medication and contacting them promptly. ^{[7] [8] [9]}
• Severe symptoms (e.g., high fever, rigors, dizziness, low blood pressure, dehydration) during therapy should prompt urgent assessment. Early intervention reduces complications and helps guide dose adjustments. ^{[7] [8]}

Bottom line

• Early melanoma is usually a skin change, not fever. ^[1]
• Fever can appear with advanced melanoma or as a treatment side effect, particularly with BRAF/MEK inhibitors and some immunotherapies. ^{[7] [8] [9]}
• Unexplained fever in the setting of cancer needs careful evaluation to rule out infection and consider tumor-related fever. ^[4]

If you’re experiencing fever and have concerns about melanoma whether newly suspected or during treatment consider discussing it with your clinician so they can determine whether it’s likely drug-related, infection, or another cause, and guide you on the safest next steps. ^{[4] [7] [8] [9]}