Management of melanoma patients during COVID‐19 pandemic in an Italian skin unit

Abstract

Due to the COVID‐19 crisis, many scheduled medical and surgical activities have been suspended. This interruption to the healthcare system can negatively affect the diagnosis and management of melanoma. Neglecting melanoma throughout the outbreak may be associated with increased rates of mortality, morbidity, and healthcare expenses. We performed a retrospective review of all dermatological and surgical activity performed in our Melanoma Skin Unit between 23 February 2020 and 21 May 2020 and compared these data with those from the same period in 2019. During the lockdown period, we observed a decrease in dermatologic follow‐up (DFU) (−30.2%) and in surgical follow‐up (SFU) (−37%), and no modification of melanoma diagnosis (−3%). Finally, surgical excisions (SE) (+ 31.7%) increased, but sentinel lymph node biopsy (SLNB) (−29%) and lymph node dissections(LND) (−64%) decreased compared to the same period in 2019. Our experience supports the continuation of surgical and diagnostic procedures in patients with melanoma during the COVID‐19 pandemic. Surgical and follow‐up procedures for the diagnosis and treatment of melanoma should not be postponed considering that the pandemic is lasting for an extended period.

COVID‐19‐related consequences on melanoma diagnoses from a local Italian registry in Genoa, Italy

“…As a logical consequence of the reduced melanoma diagnosis, also SLNB in 2020 decreased in some institutions, as observed by Filoni et al. and in our department 5 . In contrast, data reported by IMI show a slight increase in SLNB but are referred only to February–April 2020, not to all of 2020.…”

“…Filoni et al. observed a decrease of dermatological follow‐up visits during the lockdown period (−30.2%) but with a total number of melanoma diagnoses almost unchanged (64 cases in 2020 and 66 in 2019; −3%) 5 …”

Fear of Progression, Anxiety, and Depression in Patients With Advanced Melanoma in the COVID-19 and Post-COVID-19 Era

“…Immune checkpoint inhibitors and targeted therapy have improved survival outcomes of melanoma patients, however, the prognosis of patients with advanced melanoma remains unoptimistic ( 10 , 11 ). Recent researches demonstrate the unfavorable effects of COVID-19 on advanced melanoma care ( 12 – 15 ). During the COVID-19 pandemic, the diagnose, start of systemic treatment and treatment courses for advanced melanoma were frequently postponed ( 12 ).…”

Clinical Dermatology and COVID-19 Pandemic

“…One should also call attention to the importance of continued melanoma screening. [ 101 ] Screening campaigns can be adapted to the current global circumstances by focusing on the use of patient information leaflets, news outlets, and social media. [ 102 ]…”