To investigate patterns of detection and variables associated with early diagnosis of melanoma in a population at intermediate melanoma risk.Design: Survey.Setting: Hospital and university centers belonging to the Italian Multidisciplinary Group on Melanoma.Patients: Eight hundred sixteen patients who were consecutively diagnosed as having melanoma and treated at 11 participating centers.Main Outcome Measure: Relationship between patterns of detection and patient's and physician's delay with melanoma thickness, assessed by multivariate analysis.Results: A statistically significant association with early diagnosis was found for female sex (odds ratio [OR] for a lesion Ͼ1 mm in thickness, 0.70; 95% confidence interval [CI], 0.50-0.97), higher educational level (OR, 0.44; 95% CI, 0.24-0.79), residence in northern and central Italy (compared with southern Italy) (OR, 0.44; 95% CI, 0.30-0.65 and OR, 0.24; 95% CI, 0.15-0.37, respectively), and the habit of performing a skin self-examination (OR, 0.65; 95% CI, 0.45-0.93). When adjusted for all the previously mentioned variables, only melanoma detection made by a dermatologist, maybe incidentally, was associated with a statistically significant additional effect on early diagnosis (OR, 0.45; 95% CI, 0.28-0.73). No significant effect of anatomical site (trunk compared with other sites: OR, 0.83; 95% CI, 0.59-1.17), presence of atypical nevi (OR, 0.78; 95% CI, 0.52-1.17), and patient's delay (Ͼ3 months compared with Յ3 months: OR, 1.12; 95% CI, 0.78-1.60) was found. Conclusion:Future melanoma early diagnosis strategies should adequately stress the role of skin self-examination among the adult population, and should recommend that dermatologists perform a total skin examination to identify suspect lesions (such an examination should also be performed during consultations for other reasons).

BACKGROUND To the authors' knowledge, limited data are available from Mediterranean populations concerning risk factors for malignant melanoma. A few Italian case–control studies have produced conflicting results regarding the association between malignant melanoma and pigmentary traits, sunburns, and melanocytic nevi. METHODS A case–control study was conducted within the framework of the Italian Group for Epidemiologic Research in Dermatology (GISED). Twenty‐seven centers in the north and south of Italy participated. A total of 542 cases and 538 controls were entered onto the study. A standardized questionnaire was administered to cases and controls. Cases and controls also were examined by trained dermatologists who were required to count the number of melanocytic nevi (those measuring ≥ 2 mm and > 6 mm in greatest dimension, separately) and to make judgments regarding pigmentary traits. RESULTS In the multivariate analysis, eye and skin color, propensity to sunburn, history of sunburns before age 15 years, and solar lentigines all were associated with malignant melanoma. In addition, the risk of melanoma increased with the number of melanocytic nevi ≥ 2 mm. Nevi > 6 mm in greatest dimension had effects on risk that appeared to be independent from the effects of smaller nevi (2–6 mm). CONCLUSIONS The results of the current study largely are similar to those obtained in northern European countries, the U.S., and Australia and provide further evidence of the importance of selected pigmentary traits, sun exposure, and the number of melanocytic nevi in the risk of cutaneous malignant melanoma. Cancer 2000;88:2703–10. © 2000 American Cancer Society.

This study was performed to evaluate eyelid dermatitis in a group of patients of our Allergy Unit between January 1990 and April 1991. Among the 1158 patients seen during this period, 150 had eyelid dermatitis: 135 females and 15 males, with a mean age of 35 years. Of the 150 patients with eyelid dermatitis, 54 had eczema localized to the eyelids only, 49 to the eyelids and face, 19 to the eyelids and hands, and 28 to the eyelids and other sites. 98 patients (65.3%) were diagnosed as having allergic contact dermatitis, 25 (16.6%) irritant contact dermatitis, 21 (14%) atopic dermatitis, and 6 (4%) seborrhoeic dermatitis. Patch test reactions to nickel sulphate, Kathon CG and fragrance-mix occurred more frequently in patients with eyelid dermatitis than in those without.

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