Genital melanoma: are we adequately screening our patients?

Zikry, Joseph; Chapman, Lance W.; Korta, Dorota Z.; Smith, Janellen

doi:10.5070/d3233034283

Cited by 10 publications

(6 citation statements)

References 6 publications

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“…While the incidence of cutaneous malignancy at these sites is low, malignancies at these sites often present at a later stage with resultant poorer prognosis. [6][7][8][9] A key reason for missed cutaneous malignancy (melanoma and NMSC) at concealed sites is simply omission of inspection. 10 In a US study, barriers to dermatologists performing comprehensive routine FSE included practical impediments, such as availability of chaperones, limited time, and fear of professional and sexual misconduct accusations.…”

Section: Introductionmentioning

confidence: 99%

“…Concealed sites such as the scalp, breast, oral mucosa, and genitalia hold unique significance in the diagnosis of skin cancer. While the incidence of cutaneous malignancy at these sites is low, malignancies at these sites often present at a later stage with resultant poorer prognosis 6–9 . A key reason for missed cutaneous malignancy (melanoma and NMSC) at concealed sites is simply omission of inspection 10 .…”

Section: Introductionmentioning

confidence: 99%

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Full‐body skin examination in screening for cutaneous malignancy: a focus on concealed sites and the practices of Australian dermatologists

Pham,

Allen,

Star

et al. 2023

Int J Dermatology

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BackgroundFull‐body skin examination (FSE) is a vital practice in the diagnosis of cutaneous malignancy. Precisely how FSE should be conducted with respect to concealed site inclusion remains poorly elucidated.ObjectiveTo establish the approach of Australian dermatologists to concealed site examination (CSE).MethodsA cross‐sectional study was performed consisting of an online self‐administered 11‐question survey delivered to fellows of the Australasian College of Dermatologists.ResultsThere were 237 respondents. Anogenitalia was the least often examined concealed site (4.6%), and 59.9, 32.9, and 14.3% reported always examining the scalp, breasts, and oral mucosa, respectively. Patient concern was the most frequently cited factor prompting examination, while many cited low incidence of pathology and limited chaperone availability as the main barriers to routine examination of these sites.ConclusionMost Australian dermatologists do not routinely examine breasts, oral mucosal, or anogenital sites as part of an FSE. Emphasis should be made on identifying individual patient risk factors and education regarding self‐examination of sensitive sites. A consensus approach to the conduct of the FSE, including concealed sites, is needed to better delineate clinician responsibilities and address medicolegal implications.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Full‐body skin examination in screening for cutaneous malignancy: a focus on concealed sites and the practices of Australian dermatologists

Pham,

Allen,

Star

et al. 2023

Int J Dermatology

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“…Melanoma is a melanocyte‐derived malignant neoplasm that can develop on the skin or mucosa. Although the female genitalia accounts for only 0.7% of the total female body surface area, approximately 3–7% of melanomas in women are located on the vulva, vagina, and less frequently the cervix 1,2 . Associated with a 5‐year survival rate of 10%, genital melanomas portend a poor prognosis likely due to later detection than those arising elsewhere on the body 1 …”

mentioning

confidence: 99%

“…Melanoma detection occurs through either formal or incidental skin examination 2 . A formal examination consists of a skin self‐exam or a full‐body skin exam (FBSE) by a primary care physician or a dermatologist.…”

mentioning

confidence: 99%

“…A formal examination consists of a skin self‐exam or a full‐body skin exam (FBSE) by a primary care physician or a dermatologist. However, genital melanomas frequently escape early detection by dermatologists, as studies have reported that 96% of dermatologists do not examine the genitalia during FBSEs 2 . In addition, many patients delay showing their dermatologist genital lesions out of embarrassment, only reporting lesions once advanced symptoms are evident 2 …”

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confidence: 99%

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Trends in cervical cancer screening from 2007 to 2016: association with decreased genital melanoma detection in females

2021

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Full‐body skin examination in screening for cutaneous malignancy: A focus on concealed sites and the practices of international dermatologists

Pham,

Allen,

Star

et al. 2024

JEADV Clinical Practice

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BackgroundFull‐body skin examination (FSE) is fundamental to the diagnosis of cutaneous malignancy but may not always include concealed site examination (CSE).ObjectivesTo determine the approach of international dermatologists to CSE during FSE and examine influencing factors, barriers and attitudes toward CSE.MethodsMembers of the International Dermoscopy Society were surveyed using an online 12‐question survey disseminated via email.ResultsThere were 706 completed responses among 1249 unique clicks to the survey, representing a completion rate of 56.5%. Fifty‐four percent of respondents reported always examining the breasts, while 52.8%, 18.8%, and 11.8% always examined the scalp, oral, and anogenital mucosa, respectively. The most frequent reason for examining concealed sites was patient concern, whilst common reasons for not examining concealed sites included low incidence of pathology and concern regarding allegations of sexual misconduct.ConclusionsOur findings allude to the need for international consensus guidelines regarding the conduct and inclusion of concealed or sensitive sites in routine FSE. This is essential to define clinician responsibilities, inform patient expectations of care, and thereby mitigate potential medicolegal repercussions.

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Genital melanoma: are we adequately screening our patients?

Cited by 10 publications

References 6 publications

Full‐body skin examination in screening for cutaneous malignancy: a focus on concealed sites and the practices of Australian dermatologists

Full‐body skin examination in screening for cutaneous malignancy: a focus on concealed sites and the practices of Australian dermatologists

Trends in cervical cancer screening from 2007 to 2016: association with decreased genital melanoma detection in females

Full‐body skin examination in screening for cutaneous malignancy: A focus on concealed sites and the practices of international dermatologists

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