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Medline ® Abstract for Reference 97

of 'Atypical (dysplastic) nevi'

Dermatologist detection and skin self-examination are associated with thinner melanomas: results from a survey of the Italian Multidisciplinary Group on Melanoma.
Carli P, De Giorgi V, Palli D, Maurichi A, Mulas P, Orlandi C, Imberti GL, Stanganelli I, Soma P, Dioguardi D, CatricaláC, Betti R, Cecchi R, Bottoni U, Bonci A, Scalvenzi M, Giannotti B, Italian Multidisciplinary Group on Melanoma
Arch Dermatol. 2003;139(5):607.
OBJECTIVE: To investigate patterns of detection and variables associated with early diagnosis of melanoma in a population at intermediate melanoma risk.
DESIGN: Survey.
SETTING: Hospital and university centers belonging to the Italian Multidisciplinary Group on Melanoma.
PATIENTS: Eight hundred sixteen patients who were consecutively diagnosed as having melanoma and treated at 11 participating centers.
MAIN OUTCOME MEASURE: Relationship between patterns of detection and patient's and physician's delay with melanoma thickness, assessed by multivariate analysis.
RESULTS: A statistically significant association with early diagnosis was found for female sex (odds ratio [OR]for a lesion>1 mm in thickness, 0.70; 95% confidence interval [CI], 0.50-0.97), higher educational level (OR, 0.44; 95% CI, 0.24-0.79), residence in northern and central Italy (compared with southern Italy) (OR, 0.44; 95% CI, 0.30-0.65 and OR, 0.24; 95% CI, 0.15-0.37, respectively), and the habit of performing a skin self-examination (OR, 0.65; 95% CI, 0.45-0.93). When adjusted for all the previously mentioned variables, only melanoma detection made by a dermatologist, maybe incidentally, was associated with a statistically significant additional effect on early diagnosis (OR, 0.45; 95% CI, 0.28-0.73). No significant effect of anatomical site (trunk compared with other sites: OR, 0.83; 95% CI, 0.59-1.17), presence of atypical nevi (OR, 0.78; 95% CI, 0.52-1.17), and patient's delay (>3 months compared with<or =3 months: OR, 1.12; 95% CI, 0.78-1.60) was found.
CONCLUSION: Future melanoma early diagnosis strategies should adequately stress the role of skin self-examination among the adult population, and should recommend that dermatologists perform a total skin examination to identify suspect lesions (such an examination should also be performed during consultations for other reasons).
Department of Dermatology, University of Florence, Via degli Alfani 31, 501221 Florence, Italy. CARLI@unifi.it