The Vedic View of Vitiligo

Abstract

Dermatology Forum (EDF); European Association of Dermato-Oncology (EADO); European Organization for Research and Treatment of Cancer (EORTC). Diagnosis and treatment of invasive squamous cell carcinoma of the skin: European consensus-based interdisciplinary guideline.

Melanoma In Situ—Getting the Diagnosis and Prognosis Right

“…There are several implications from the study by Patel et al for a patient with a diagnosis of melanoma in situ; one of these is a heightened risk of developing a subsequent primary melanoma and thus a need for ongoing routine skin checks. Using the SEER data, Patel et al found that after a diagnosis of melanoma in situ, the 15-year cumulative incidence was 8.9% for a second primary invasive melanoma and 14.1% for a second primary melanoma in situ. This is consistent with other studies .…”

“…In this issue of JAMA Dermatology , Patel and colleagues examine mortality after a diagnosis of melanoma in situ. Melanoma in situ is the earliest stage of melanoma (stage 0) and is localized to the outermost layer of skin (epidermis).…”

“…To reflect this theoretical 0 risk, which contrasts with many patients’ perceived significant risk of tumor recurrence, it has even been proposed that the term melanoma in situ be replaced with terminology that removes reference to melanoma . However, to our knowledge, there are few published data to confirm the mortality risk, a gap that Patel and colleagues address in their article using US population-based data from 18 Surveillance, Epidemiology, and End Results (SEER) registries for people with a diagnosis of a first primary cutaneous melanoma in situ between 2000 and 2018. Among 137 872 patients who had a melanoma in situ as their first and only melanoma diagnosis, Patel et al found that 15-year melanoma-specific survival was 98.4%.…”

“…However, to our knowledge, there are few published data to confirm the mortality risk, a gap that Patel and colleagues address in their article using US population-based data from 18 Surveillance, Epidemiology, and End Results (SEER) registries for people with a diagnosis of a first primary cutaneous melanoma in situ between 2000 and 2018. Among 137 872 patients who had a melanoma in situ as their first and only melanoma diagnosis, Patel et al found that 15-year melanoma-specific survival was 98.4%. This is similar to the 98% 10-year melanoma-specific survival reported for people with a diagnosis of a T1a melanoma (<0.8 mm without ulceration) reported by the American Joint Committee on Cancer large international database, and the more than 98% 20-year melanoma-specific survival observed after diagnosis of a single invasive melanoma with a Breslow thickness less than 0.6 mm in Queensland, Australia …”

“…Based on these data, it appears that melanoma-specific mortality associated with a diagnosis of melanoma in situ is similar to that for a very thin invasive melanoma. Despite a theoretical 0 mortality risk, Patel and colleagues describe several but not all of the reasons that might explain why some people die of their melanoma in situ. One reason is that misclassification may be associated with the use of a partial biopsy technique, in which a focus of dermal invasive melanoma is not included in the biopsy specimen, and invasive melanoma may be left undetected in the patient where it may continue to grow.…”