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Multicenter Study
. 2012 Sep;67(3):e105-9.
doi: 10.1016/j.jaad.2011.11.949. Epub 2012 Jan 9.

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

Sherea M Stricklin  1 , William V Stoecker, Joseph M Malters, Rhett Drugge, Margaret Oliviero, Harold S Rabinovitz, Lindall A Perry
Affiliations
Multicenter Study

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

Sherea M Stricklin et al. J Am Acad Dermatol. 2012 Sep.

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 United States.

Methods: This study collected 257 MIS cases from 4 private dermatology practices in the United States 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 men. The median age of patients at the time of MIS detection was 69 years. The most common site for MIS was the head-neck region. The number of MIS cases collected exceeded the number of invasive malignant melanoma cases during the study period, with an observed ratio of 1.35:1.

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 less than 4 mm, on sun-exposed areas, including scalp, trunk, and feet, will facilitate earlier diagnosis of MIS. As only 30.4% of male patients and 50% of female patients had concern about these lesions, it still falls to the dermatologist to discover MIS.

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Figures

Figure 1
Figure 1
Occurrence of melanoma in situ by age: 257 melanomas in situ, 4 private practice clinics in Plantation, Florida; Columbia and Rolla, Missouri; and Stamford, Connecticut: 2005–2009.
Figure 2
Figure 2
Anatomic location: 257 melanomas in situ, 4 private practice clinics in Plantation, Florida; Columbia and Rolla, Missouri; and Stamford, Connecticut: 2005–2009.
See this image and copyright information in PMC

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