Thin primary cutaneous melanomas

Abstract

BACKGROUNDPublic awareness and education may lead to the detection of thinner melanomas, which may result in a decrease in morbidity and mortality rates. Which detection patterns, lesion, and patient characteristics are associated with early detection?METHODSUsing the University of Michigan prospective melanoma database, the detection patterns, lesion characteristics, and patient characteristics of 1515 consecutive patients with in situ or invasive cutaneous melanomas were reviewed. Tumor thickness (measured in millimeters) was evaluated in relationship to detection patterns (patient, physician, spouse), lesion characteristics (change in color, size, shape/elevation, ulceration, bleeding, tenderness, itching), and patient characteristics (gender, skin type, number of atypical and clinically benign nevi, history of sunburn, personal and family history of melanoma).RESULTSPatient characteristics associated with early detection included female gender, at least one atypical nevus, greater than 20 clinically benign nevi, and/or a personal history of melanoma. Skin types I, II, and III, a history of sunburn, and/or a family history of melanoma were also associated with thinner lesions, but these associations were not statistically significant. Lesion characteristics associated with earlier detection included a change in color, size, shape/elevation, and/or itching. Physician‐detected melanomas were significantly thinner than patient or spouse‐detected lesions.CONCLUSIONSEducational campaigns should include increasing melanoma awareness in males and educating the public on the early signs and symptoms. Education should be directed at both high and low‐risk groups. Physicians should consider performing total skin examinations routinely on patients. Although they detect a relatively small percentage of all melanomas, physicians detect significantly thinner lesions. Cancer 2002;95:1562–8. © 2002 American Cancer Society.DOI 10.1002/cncr.10880

The lncRNA SLNCR1 Mediates Melanoma Invasion through a Conserved SRA1-like Region

“…In the years since this study, other studies have confirmed that females have a significant survival advantage compared to males (38%), fewer and delayed metastases, longer delay before relapse, and higher cure rates than males, strongly suggesting a biological basis for the observed gender bias (Bidoli et al, 2012; de Vries et al, 2007; Fisher and Geller, 2013; Gamba et al, 2013; Geller et al, 2002; Joosse et al, 2012; Joosse et al, 2011; Schwartz et al, 2002; Swetter et al, 2009). Differences in expression or activity of sex-hormone receptors, including the estrogen receptor or AR, have long been considered a plausible explanation for the melanoma gender bias (de Giorgi et al, 2011; Morvillo et al, 2002).…”

Vulvar melanoma: a report of 20 cases and review of the literature

“…This finding is in contrast to the mean Breslow depth in an analysis from the University of Michigan multidisciplinary melanoma clinic consisting of 1,515 consecutive cases of cutaneous melanoma with a mean Breslow depth of 1.02 mm (25% in situ) presumably due to earlier detection on the skin. 42 While the numbers are small, the frequency of ulceration in our series was interesting. Eleven (58%) of 19 invasive vulvar melanomas were ulcerated, with ulceration in 1 (17%) of 6 lesions having a Breslow depth of Յ1 mm (vs 6% for cutaneous melanoma); 2 (50%) of 4 lesions with depths of 1.1-2 mm (vs 23% for cutaneous melanoma); 3 (75%) of 4 lesions with depths of 2.1-4 mm (vs 47% for cutaneous melanoma); and 5 (100%) of 5 lesions with depths of Ͼ4 mm (vs 63% for cutaneous melanoma).…”

First Prospective Study of the Recognition Process of Melanoma in Dermatological Practice

“…21 In this regard, the fact that an MM was found in 9 (1.68%) of the 535 nevi that were removed only to reassure the patient should lead physicians to listen carefully to patients who want a mole resected, because patients may perceive subtle changes that they may be unable to communicate.…”