Nodular Melanoma Is Not a Distinct Entity—Reply

Chamberlain, Alex J; Fritschi, Lin; Giles, Graham G.; Dowling, John P.; Kelly, John W.

doi:10.1001/archderm.139.3.387-a

Cited by 13 publications

(8 citation statements)

References 5 publications

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“…5 Recent studies raised concern about the reliability of such classification, even if the separation between superficial spreading melanoma and nodular melanoma seemed more reliable than that among other histotypes; 6 anyway, this is still an open question. [15][16][17][18][19][20] Up to now, the above-mentioned classification remains valid and remind us that nodular melanomas manifest clinically in a quite distinct way compared to melanomas that begin with radial growth phase. In their earlier form, nodular melanomas are frequently small in diameter, regular in shape, and amelanotic.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Detection of Superficial Spreading and Nodular-Type Melanoma: A Multicenter Italian Study

et al. 2004

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Section: Discussionmentioning

confidence: 99%

Patterns of Detection of Superficial Spreading and Nodular-Type Melanoma: A Multicenter Italian Study

et al. 2004

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“…This does not represent an exception. Chamberlain et al 20 as well as other authors 21,22 reported a certain number of cases of NM less than 1 mm thick. It is obvious that caution must be used in every thickness of melanoma, so patients with melanoma of any thickness must be prudently followed up because thickness is not the only factor to be considered in the prognosis.…”

Section: Discussionmentioning

confidence: 85%

“…There are also histopathological problems of melanoma and patterns of detection of tumors. 4,20 The main measurable and reproducible histopathological factor related to delay is the thickness of the tumor or its function as the rate of growth. 23 The importance of the correlation of thickness and delay lies in the implications on prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…Patterns of detection of tumors are other factors eventually involved in diagnostic delay of melanoma and are of great importance with reference to their implications for earlier diagnosis 4,20 and to know the biological behavior of a lesion. A recent report further strengthens the importance of the anamnestic data as the only way to assess the delay and as an indirect index of clinical growth.…”

Section: Discussionmentioning

confidence: 99%

“…It was observed that the majority of NM have been more frequently self-detected than SMM. 20 It is possible that the shorter period of evolution of NM limits the opportunity of detection by physicians while a fast-growing lesion is more likely to draw the attention of the patient. The changing evolution and not the asymmetry, the color or the border, is the striking feature.…”

Section: Discussionmentioning

confidence: 99%

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Nodular melanomas: Analysis of the casistic and relationship with thick melanomas and diagnostic delay

Betti

Martino

Vergani

et al. 2008

The Journal of Dermatology

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The present study aimed to: (i) define thick melanomas related to nodular melanomas and other melanoma subgroups; and (ii) establish diagnostic delay in relation to the biological behavior of these melanomas and prevention programs. Cutaneous primary melanomas were studied. Nodular melanoma (NM), lentigo maligna melanoma (LMM) and superficial spreading melanoma (SSM) were selected. A further category named vertical growth melanoma (VGM) was also utilized. Analysis for sex, age, different values of thickness (1-2 mm, > 2 mm; 1-3 mm, > 3 mm; > 4 mm), delay to diagnosis and patterns of detection were performed in all of the different subtypes. Eighty-seven patients with melanomas more than 1 mm of Breslow's thickness out of 506 melanoma were collected. Twenty-six were nodular cases, 39 SSM, five LMM and 17 VGM. Of those patients with NM, 42% had a thickness of more than 1-2 mm, 34% of 2-4 mm, 23% of more than 4 mm; and 54% with 1-3, 46% with more than 3 mm; and 58% with more than 2 mm. Even considering different values of thickness of more than 1 mm, a delay to diagnosis was significantly lower in NM (4.79 months) than in other subgroups. The value of more than 1 mm of Breslow's thickness may be sufficient to consider a melanoma to be thick. The lower diagnostic delay of NM suggests that they represent faster growing lesions probably with a different biological behavior than other melanoma subtypes. VGM should not be confused with NM, having a longer delay and different clinical features compared with the latter. They represent an area of diagnostic carelessness than potentially be improved.

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