Carolina Pereda

Instituto Valenciano de Oncologia, Valenza, Valencia, Spain

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Publications (3)3.2 Total impact

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    ABSTRACT: Background and objectiveAcral lentiginous melanomas —the melanomas most commonly found on the distal portions of the limbs— have usually reached more advanced stages than other types of melanoma when diagnosed. Our aim was to describe the clinical presentation of these tumors.Materials and methodsRetrospective, descriptive, observational study of cases recorded in the database of the Instituto Valenciano de Oncología. In telephone interviews the patients answered a questionnaire on the presenting features of the lesion, on the presence of signs and symptoms included in the Glasgow 7-point checklist and the ABCDEs of melanoma, and on diagnostic delay attributable to patient or physician.ResultsIn the interviews with the 23 patients who responded to the questionnaire, we detected a diagnostic delay of more than 1 year attributable to the patient (delay in seeking care) in 30.4% of the cases. Diagnostic delay of more than 1 year attributable to the physician (failure to suspect the diagnosis) was identified in 20%. The most frequent reasons for consulting a physician about a lesion were changes in size, changes in color, bleeding, or failure to heal. In 20% of the cases the evaluating physician did not order histology for over a year.Conclusions Diagnostic delay is a significant problem in acral lentiginous melanoma and may be attributable either to patients or to physicians’ failure to recognize warning signs. Melanoma prevention campaigns should place more emphasis on the possibility of melanomas appearing on the palms and, particularly, on the soles.
    Actas Dermo-Sifiliográficas 04/2013; 104(3):220–226.
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    ABSTRACT: BACKGROUND AND OBJECTIVE: Acral lentiginous melanomas-the melanomas most commonly found on the distal portions of the limbs-have usually reached more advanced stages than other types of melanoma when diagnosed. Our aim was to describe the clinical presentation of these tumors. MATERIALS AND METHODS: Retrospective, descriptive, observational study of cases recorded in the database of the Instituto Valenciano de Oncología. In telephone interviews the patients answered a questionnaire on the presenting features of the lesion, on the presence of signs and symptoms included in the Glasgow 7-point checklist and the ABCDEs of melanoma, and on diagnostic delay attributable to patient or physician. RESULTS: In the interviews with the 23 patients who responded to the questionnaire, we detected a diagnostic delay of more than 1 year attributable to the patient (delay in seeking care) in 30.4% of the cases. Diagnostic delay of more than 1 year attributable to the physician (failure to suspect the diagnosis) was identified in 20%. The most frequent reasons for consulting a physician about a lesion were changes in size, changes in color, bleeding, or failure to heal. In 20% of the cases the evaluating physician did not order histology for over a year. CONCLUSIONS: Diagnostic delay is a significant problem in acral lentiginous melanoma and may be attributable either to patients or to physicians' failure to recognize warning signs. Melanoma prevention campaigns should place more emphasis on the possibility of melanomas appearing on the palms and, particularly, on the soles.
    Actas Dermo-Sifiliográficas 03/2013;
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    ABSTRACT: Acral lentiginous melanoma (ALM) is a distinct histological variant of cutaneous melanoma that presents a genomic profile different from the other variants. Our aim was to explore the distinctive clinical, pathological, and epidemiological characteristics of ALM. A series of 978 patients with primary cutaneous melanoma was selected from a single referral center. Among these, 79 were located on acral sites and 46 presented an ALM. This group was compared with a group composed of 932 patients with the remaining three most frequent cutaneous melanoma variants. The ALM differed significantly from other variants: in an older age at diagnosis (65.52 vs. 51.79 years), a lower number of common (88.2 vs. 55.8%) and atypical nevi (95.0 vs. 80.2%), a predisposing genetic trait to cancer (22.2 vs. 7.1% had a personal history of other non-cutaneous malignancies and 58.1 vs. 36.4% had at least one first degree relative with non-cutaneous neoplasia) and lower number of sunburns (88.2 vs. 47.4% remembered none). Also, the tumors were thicker (mean of 2.94 vs. 2.03 mm), more frequently ulcerated (74.2 vs. 23.9%) and with perineural invasion (8.0 vs. 1.5%), had lower degree of inflammatory infiltrate (36.8 vs. 7.5% was absent) and were less frequently associated with a previous melanocytic lesion (8.3 vs. 32.6%). Differences were kept even after age-adjusted analyses. Our results, from a clinical and epidemiological point of view, support recent data on genetic characterization of melanomas. In comparison with the other frequent variants we have shown that ALM has some important differences which emphasize that it is a distinct entity more probably related to certain cancer susceptibility but unrelated to familial melanoma, tendency to developing nevus or sun exposure.
    Cancer Causes and Control 09/2008; 20(1):115-9. · 3.20 Impact Factor