Michelle Y Cheng1, Jacqueline F Moreau1, Sean T McGuire2, Jonhan Ho3, Laura K Ferris4. 1. University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. 2. Department of Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania. 3. Department of Dermatology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. 4. Department of Dermatology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Electronic address: ferrlk@upmc.edu.
Abstract
BACKGROUND: The impact of having an established dermatologist on melanoma depth at diagnosis is incompletely understood. OBJECTIVE: We sought to determine whether having had a previous dermatologic examination (an established dermatologist), the recency of the last examination, and the wait time for the dermatology appointment are associated with melanoma invasiveness and depth. METHODS: This was a retrospective cross-sectional study of 388 patients with primary melanoma at an academic dermatology department. RESULTS: Patients with an established dermatologist were more likely than patients without an established dermatologist to be given a diagnosis of melanoma in situ (103/162 [63.6%] vs 69/155 [44.5%], P = .001) and to have thinner invasive melanoma (0.48 [0.30-0.71] mm vs 0.61 [0.40-1.10] mm, respectively, P = .003). These trends were observed for patients with self-detected, but not dermatologist-detected, melanoma. Patient-detected melanomas made up 184/361 (51.0%) of all melanomas, 83/199 (41.7%) of in situ melanomas, and 101/162 (62.4%) invasive melanomas. Self-detected melanomas were in situ in 36 of 61 (59.0%) patients with an established dermatologist versus 40 of 108 (37.0%) patients without an established dermatologist, P = .006. Neither time from last dermatologic examination nor wait time for an appointment was associated with melanoma invasiveness or depth. LIMITATIONS: Data are retrospective and from 1 large academic health care system. CONCLUSION: Education obtained at the dermatology appointment may improve early self-detection of melanoma, and having an established dermatologist may facilitate earlier evaluation of concerning lesions.
BACKGROUND: The impact of having an established dermatologist on melanoma depth at diagnosis is incompletely understood. OBJECTIVE: We sought to determine whether having had a previous dermatologic examination (an established dermatologist), the recency of the last examination, and the wait time for the dermatology appointment are associated with melanoma invasiveness and depth. METHODS: This was a retrospective cross-sectional study of 388 patients with primary melanoma at an academic dermatology department. RESULTS:Patients with an established dermatologist were more likely than patients without an established dermatologist to be given a diagnosis of melanoma in situ (103/162 [63.6%] vs 69/155 [44.5%], P = .001) and to have thinner invasive melanoma (0.48 [0.30-0.71] mm vs 0.61 [0.40-1.10] mm, respectively, P = .003). These trends were observed for patients with self-detected, but not dermatologist-detected, melanoma. Patient-detected melanomas made up 184/361 (51.0%) of all melanomas, 83/199 (41.7%) of in situ melanomas, and 101/162 (62.4%) invasive melanomas. Self-detected melanomas were in situ in 36 of 61 (59.0%) patients with an established dermatologist versus 40 of 108 (37.0%) patients without an established dermatologist, P = .006. Neither time from last dermatologic examination nor wait time for an appointment was associated with melanoma invasiveness or depth. LIMITATIONS: Data are retrospective and from 1 large academic health care system. CONCLUSION: Education obtained at the dermatology appointment may improve early self-detection of melanoma, and having an established dermatologist may facilitate earlier evaluation of concerning lesions.
Authors: Loraine A Escobedo; Ashley Crew; Ariana Eginli; David Peng; Michael R Cousineau; Myles Cockburn Journal: Health Place Date: 2017-04-06 Impact factor: 4.078
Authors: Alyce Anderson; Laura K Ferris; Benjamin Click; Claudia Ramos-Rivers; Ioannis E Koutroubakis; Jana G Hashash; Michael Dunn; Arthur Barrie; Marc Schwartz; Miguel Regueiro; David G Binion Journal: Dig Dis Sci Date: 2018-04-30 Impact factor: 3.199
Authors: Raquel Bissacotti Steglich; Silvana Cardoso; Maria Helena da Costa Naumann Gaertner; Karina Munhoz de Paula Alves Coelho; Tania Ferreira Cestari; Selma Cristina Franco Journal: An Bras Dermatol Date: 2018 Jul-Aug Impact factor: 1.896