Melanoma in situ in a private practice setting 2005 through 2009: Location, lesion size, lack of concern

Abstract

Background Studies have shown that the incidence of melanoma in situ (MIS) is increasing significantly. Objective This study analyzes selected clinical and demographic characteristics of MIS cases observed in private dermatology practices in the US. Methods This study collected 257 MIS cases from 4 private dermatology practices in the US from January 2005 through December 2009, recording age, gender, anatomic location, lesion size, patient-reported change in lesion and concern about lesion. Case totals for invasive melanoma during the same period were recorded. Results The data collected showed a higher incidence of MIS in sun-exposed areas of older patients, especially males. The median age of patients at the time of MIS detection was 69. The most common site for MIS was the head-neck region. The number of MIS cases collected exceeded the number of invasive malignant melanoma (MM) cases during the study period, with an observed ratio of 1.37:1. Limitations For 136 patients, data were collected retrospectively for lesion size, location, gender, and age. For these patients, patient-reported change in lesion and concern about lesion were not collected. Patients often did not consent to a full body examination, therefore, it is possible that MIS lesions may have been missed in double-clothed areas. Conclusion Careful attention to pigmented lesions, even lesions < 4mm, on sun-exposed areas, including scalp, trunk, and feet, will facilitate earlier diagnosis of MIS. As only 30.4% of males and 50% of females had concern about these lesions, it still falls to the dermatologist to discover MIS.

An integrated clinical‐dermoscopic risk scoring system for the differentiation between early melanoma and atypical nevi: the iDScore

“…[38][39][40] According to epidemiologic predictive model for MM, this trend is supposed to further increase due to the population ageing phenomenon. In particular, latest European data reveal an increase in incidence of MM in people aged >60 years and median age at diagnosis for in situ MM of 69 years.…”

“…[38][39][40] According to epidemiologic predictive model for MM, this trend is supposed to further increase due to the population ageing phenomenon. [38][39][40][41][42][43][44][45] Indeed, although it is traditionally accepted that sunburns and intermittent exposures are linked with MM development in rarely exposed body areas and continuous/occupational UV exposure is associated with MM development on chronically exposed body areas, 39-42 a quote of patients seems to develop MM without a directly link to UV exposure (i.e. upper extremities including head, neck, arms and hands) and group B of frequently photoexposed body areas (i.e.…”

Cutaneous Melanoma: Preoperative Tumor Diameter in a General Dermatology Outpatient Setting

“…Thus, it is not surprising that none of the previously published studies was population based. Only two of the nine studies that reported preoperative tumor measures were from the United States; neither of these studies was based on information from a single dermatology practice, one of the studies comprised patients seen at multiple centers by CM specialists or dermatologists with a high volume of biopsies, and the other study included in situ CM cases only …”

“…Only two of the nine studies that reported preoperative tumor measures were from the United States 16,18 ; neither of these studies was based on information from a single dermatology practice, one of the studies comprised patients seen at multiple centers by CM specialists or dermatologists with a high volume of biopsies, 16 and the other study included in situ CM cases only. 18 Our study included tumor diameter only if recorded measures were available preoperatively (in vivo). In five of the available published reports on tumor diameter (Table 5), measures were obtained after tumor excision and tissue processing (ex vivo).…”

Patient concern as a predictor of cutaneous malignancy

“…We retrospectively analysed 3080 patient encounters for 3619 lesions in four US private practice dermatology clinics (Rolla, MO; Columbia, MO; Plantation, FL; Stamford, CT) enrolled in a dermoscopy‐aided melanoma diagnosis study (NIH‐R44‐CA101639‐02A2) . Phelps County Regional Medical Centre's institutional review board (Rolla, MO, U.S.A.), approved this study; consent was obtained for each participant.…”