Screening for cutaneous melanoma.
ABSTRACT Current data do not support widespread population-based screening for melanoma. While the incidence of melanoma is high, the overall mortality is low, and thus any potential benefit of screening the general population is hard to demonstrate. No randomized controlled trial showing reduction in mortality has ever been completed and, given the expense and time necessary for such a trial, probably will never be completed. The idea of skin screening remains appealing for this common, visible malignancy which is eminently treatable when detected early. Efforts should be focused on populations at particularly high risk of developing melanoma and on those at high risk of death from melanoma once diagnosed. Persons in kindreds of familial melanoma, and persons who have atypical mole syndrome, those who have a prior diagnosis of melanoma, or those who have diagnosed atypical nevi are all reasonable candidates for routine screening, based on lower-level evidence in the absence of randomized clinical trials targeting these groups. Programs targeting persons of low socioeconomic status and targeting white men over the age of 50 could address groups known to beat especially high risk of melanoma mortality.
- SourceAvailable from: Wilma Bergman
Article: Management of Melanoma Families.[Show abstract] [Hide abstract]
ABSTRACT: In this review we have aimed to focus on the clinical management of familial melanoma patients and their relatives. Along this line three major topics will be discussed: (1) management/screening of familial melanoma families: what is advised and what is the evidence thereof; (2) variability of families worldwide with regard to clinical phenotype, including cancer spectrum and likelihood of finding germline mutations and (3) background information for clinicians on the molecular biology of familial melanoma and recent developments in this field.Cancers. 01/2010; 2(2):549-566.
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ABSTRACT: The biopsy lies at the heart of the management of the suspected melanocytic neoplasm. Dermatologists are the ideal physicians to examine patients with suspect melanocytic lesions and an understanding of when and how to perform a biopsy is vital. Various algorithms have been formulated to allow for facilitation of the clinical examination, including the ABCDE rule, the Glasgow 7-point checklist, and the "ugly duckling" sign. Along with this, dermoscopy can increase the sensitivity of diagnosis. Proper training regarding dermatoscopy is essential, especially with algorithms such as the Menzies method, the 7-point checklist, and pattern analysis. Digital photography and digital dermatoscopy allows for surveillance of suspect nevi or patients with multiple nevi. For neoplasms suspected of being melanoma, an excision for diagnosis with 1- to 3-mm borders is ideal, although a shave, punch, or other incisional biopsy can be performed in special circumstances. Finally, research has allowed for promising technologies including gene profiling of tape-stripped samples along with automated software analysis of digital dermatoscopic images.Journal of the American Academy of Dermatology 09/2008; 59(5):852-71. · 4.91 Impact Factor
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ABSTRACT: We demonstrate the use of gold nanorods as molecularly targeted contrast agents for two-photon luminescence (TPL) imaging of cancerous cells 150 µm deep inside a tissue phantom. We synthesized gold nanorods of 50 nm x 15 nm size with a longitudinal surface plasmon resonance of 760 nm. Gold nanorods were conjugated to antibodies against epidermal growth factor receptor (EGFR) and labeled to A431 human epithelial skin cancer cells in a collagen matrix tissue phantom. Using a 1.4 NA oil immersion objective lens, we found that excitation power needed for similar emission intensity in TPL imaging of labeled cells was up to 64 times less than that needed for two-photon autofluorescence (TPAF) imaging of unlabeled cells, which would correspond to a more than 4,000 times increase in emission intensity under equal excitation energy. However, the aberrations due to refractive index mismatch of the immersion oil and the sample limit imaging depth to 75 µm. Using a 0.95 NA water immersion objective lens, we observe robust two-photon emission signal from gold nanorods in the tissue phantoms from at depths of up to 150 µm. Furthermore, the increase in excitation energy required to maintain a constant emission signal intensity as imaging depth was increased was the same in both labeled and unlabeled phantom, suggesting that at the concentrations used, the addition of gold nanorods did not appreciably increase the bulk scattering coefficient of the sample. The remarkable TPL brightness of gold nanorods in comparison to TPAF signal makes them an attractive contrast agent for early detection of cutaneous melanoma.Proc SPIE 01/2007;