Dermatologists discovered more in situ, thinner melanomas
Melanomas were more likely to be detected as a result of a
dermatologist-initiated full-body skin examination than due to patient
complaint, according to the results of a retrospective study.
In addition, the melanomas discovered by the dermatologists were thinner
and in an earlier stage, suggesting that “minimizing the substantial
public health and financial impact of melanomas may be aided by a
full-body skin examination,” according to researchers.
Two researchers performed a retrospective analytical case series on 126
patients with melanomas treated at a private dermatology practice from July
2005 to October 2008. There were 51 incidences of invasive disease and 75
instances of in situ melanomas.
Of all melanomas found, 56.3% were found by dermatologists and were not
part of the presenting complaint. Overall, 60% of melanomas in situ were found
by dermatologists. A higher mean percentage of melanomas detected by physicians
were in situ compared with those detected by patients (63.4% vs. 54.5%).
Dermatologists were also more likely to discover melanoma when it was
thinner; mean depth was 0.33 mm in the physician-detected group vs. 0.55 mm in
the patient-detected group. The researchers found a statistically significant
association between increasing melanoma depth and patient detection (OR=2.39).
Conversely, dermatologist detection was associated with thinner melanomas
(OR=0.42).
In an accompanying editorial, Daniel G. Federman, MD, a professor of medicine with Yale
School of Medicine, and colleagues said that although the results were
“provocative” they are “not definitive.”
Federman wrote that the “possibility of detecting cancers before
they become more invasive is very appealing, especially when such a low-tech,
well-accepted, relatively quick, inexpensive, noninvasive test — such as
the full-body skin examination — is involved.”
Kantor J. Arch Dermatol. 2009;145:873-876.
More In the Journals summaries>>