The epidemiology, prevention, and detection of melanoma.

Ochsner Cancer Institute, Department of Surgery Ochsner Clinic Foundation, New Orleans, LA.
Ochsner Journal 01/2010; 10(2):56-65.
Source: PubMed

ABSTRACT We are seeing a record number of newly diagnosed skin cancers worldwide, with the incidence of melanoma increasing at a faster rate than almost all other cancers. As clinicians, we will have, by far, the greatest impact on reducing this incidence through better methods of early detection of melanoma and proven prevention methods and techniques. The medical community must enhance its efforts to increase its training of new health care personnel who are capable of diagnosing and treating this record number of patients with skin cancer. We must also try to increase the access to our limited number of dermatologists and provide novel ways of patient education such as through skin self-examinations, total body photography, and improved education for our children. By providing easier access to skin examinations, we will increase our chances of detecting melanoma in its earliest and most curable form. The dangers of indoor tanning beds and salons must be transparent to those that use them, focusing on expanding the oversight of such facilities by our local and federal governmental agencies while establishing legislation in several states to further limit their use to our youth, who are especially at high risk for developing melanoma in the future. This review will focus on the epidemiology, prevention, and detection of melanoma.

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    ABSTRACT: Subungual melanoma, a relatively uncommon disease, has a worse prognosis than cutaneous melanoma in other sites. Both this life-threatening disease and its treatment cause cosmetic and functional impairment to the patient. The diag-nosis is often delayed and resulting an advanced disease at presentation. The important clinical manifestation, diagnosis and latest treatments for subungual melanoma are reviewed. Electronic databases of Medline, PubMed, and the Coch-rane library were searched with the key word "subungual melanoma". A clinical scoring system is proposed by the au-thors to stratify patients to undergo biopsy, making earlier diagnosis of this disease possible. The latest trend of treat-ment involves wide local excision at a more distal level of the affected digit, in contrast to radical amputation of the digit in the past. Studies have shown that this does not decrease the survival nor increase local recurrence, but reduces the functional impairment for the patient. This review aims to summarise the approach to subungual melanoma for cli-nicians, so that they can recognise and diagnose this disease early and generate the best functional and cosmetic out-come for the patients.


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