The effect of COVID-19 emergency in the management of melanoma in Italy

Abstract

The COVID-19 pandemic has severely hampered the functioning of any health system, absorbing a considerable amount of resources and with the threat of widespread infection in the health services. The present survey has been carried out in Italy to evaluate if and how COVID-19 also affected skin melanoma management. We enrolled 13 Italian centres highly qualified in the diagnosis and care of skin melanoma. We compared a set of information evaluating the amount of activity for melanoma performed during February-April 2020 with the same quarter in 2019. The number of new melanoma diagnosis, biopsies, wide local excisions, overall pathology reports decreased. However, the most severe cases seem promptly managed with sentinel lymph node biopsies, new systemic treatments (north) and the total number of (advanced) treated patients (centre-south). The COVID-19 experience has underlined the need to exploit the help which may come from telemedicine.

Optimising the Management of Malignant Melanoma during COVID-19

“…Westen et al summarizes an American experience, with significant increases in tumour thickness and ulceration and advanced tumour stages. Similar findings were exhibited in Spanish and Italian populations 8 , 10 . As reflected in UK plastic surgery departments, our unit adopted a prompt telemedicine service for patients 1 , 4 , 5 , 11 , 12 .…”

“…Early diagnosis and treatment is the core principle in the prevention of morbidity and mortality of the disease. Early observers during the pandemic noted significantly more aggressive disease following regional lockdowns with respect to previous controlled time-periods 6 , 8 . This decrease is contrary to our units experience of both invasive and non-invasive melanoma during the coronavirus pandemic thus far.…”

Melanoma Management during the COVID-19 Pandemic Emergency: A Literature Review and Single-Center Experience

“…Generally, in Italy from February 2020 to April 2020, the Intergruppo Melanoma Italiano (IMI) detected a substantial reduction in the number of first visits (−31.3%) and biopsies (−36.5%), with a decrease of approximately 25% in histological diagnoses, and a 22.9% reduction in wide local excisions in comparison to 2019. As a result, there was a 20.8% reduction in the number of patients starting systemic therapy [ 13 ].…”

Soins de fin de vie

“…• Les habitants de zones défavorisées, ainsi qu'il ressort d'études sur l'Allemagne, la Belgique, la juillet 2020, le taux de mortalité due au COVID-19 dans les zones les plus déshéritées était 2.2 fois plus élevé, en Angleterre, que dans les zones les moins démunies (ONS, 2020 [55]).…”