Suspected melanoma only when the lesion is greater than 6mm may harm patients

Abstract

Objective To analyze the distribution of larger diameter in the pathological report of cutaneous melanoma patients.Methods Data were obtained from patients seen from 1994 to 2015. Date, sex, age, maximum diameter, histological subtype, primary site, microscopic thickness, mitoses, ulceration, vertical growth phase, and regression were the variables studied. This study was approved by the National Ethics Committee - Brazil Platform. Patients were grouped into smaller diameter (≤6mm) and larger diameter (>6mm). The statistical analysis used the χ2 test (p<0.05).Results Of the 292 patients analyzed, 123 were seen between 1994 and 2004, and 169 between 2005 and 2015; in that, 151 women and 141 men, mean age of 52 years. The diameters ranged from 2 to 76mm (mean of 14mm), 81 patients with smaller diameter (≤6mm) and 211 with larger diameter (>6mm). Out of 81 patients with smaller diameter, 29 had invasive melanoma, while 179 of the 211 with larger diameter were invasive. A difference was observed in frequency of vertical growth phase.Conclusion Pigmented skin lesions with diameter smaller than 6mm should not be an excluding factor for biopsies, especially when patients present risk of developing skin cancer.

Epidemiological, clinical and histological aspects of cutaneous melanoma of the head and neck region

“…The predominant histologic subtype was the superficial extensive (47.8%), followed by nodular (26.1%), like found in other studies [11][12][13] . Superficial extensive melanoma is usually the most prevalent and the least aggressive.…”

“…The age of the patients varied from 15 to 87 years, being the average age 60.4 years. The average age found was slightly higher than other studies, which ranged from 51.1 to 55 years 4,11,12 . Melanoma can affect any age group, being more common in people with more advanced age.…”

“…As for gender, most of the patients were women (56.7%). In most studies there was also female predominance 4,5,11 . According to Brandão et al 4 , in countries with low incidence of cutaneous melanoma, such as Brazil, female is usually more prevalent.…”

“…Most of the lesions were bigger than 6 mm, however, although the ABCD rule is diameter bigger than 6 mm, it is necessary to be aware of lesions with smaller diameters that encourage early diagnosis 11 .…”

Melanocytic lesions ≤ 6mm: Prospective series of 481 melanocytic trunk and limb lesions in Brazil

“…With the advent of the dermatoscope and routine examination of pigmented lesions, the number of melanomas in initial stages with sizes under the classic 6mm in diameter criterion by ABCD for CM are increasingly being detected [ 3 – 16 ]. This new dimensional frontier for melanomas has been reported in the literature in case reports as well as in case series, predominantly comparing them with larger melanomas, with many articles using the histopathological dimensions of the lesions [ 17 – 24 ].…”