"Catalyst" symptoms in malignant melanoma.

Despite efforts to identify and cure early melanoma, mortality from this potentially curable disease continues to increase. In a retrospective analysis of the charts of 568 patients treated for superficial spreading melanomas during a ten-year period, the authors studied the relations between type of symptom, symptom duration, and thickness of the lesion. "Catalyst" symptoms, the particular events that preceded diagnosis, were identified. Patients described 75 different catalyst symptoms or symptom combinations. Bleeding precipitated prompt medical attention but was associated with the deepest lesions (mean thickness 1.77 mm); ulceration, itching and tenderness were associated with delays of several months and lesions of intermediate thickness (1.13 to 1.28 mm); and changes in size, color, or elevation eventuated in diagnosis an average of a year after patients' observations of these changes, with mean lesion thickness of .80 mm to 1.33 mm. Patients react slowly to signs and symptoms of early melanoma.