Strategies for early recognition of cutaneous melanoma—present and future

Strategies for early recognition of cutaneous melanoma—present and future

Authors

  • Franziska Brehmer Department of Dermatology, Venerology and Allergology, Georg August University, Göttingen, Germany
  • Marina Ulrich Department of Dermatology, Venerology and Allergology, Charité Universitätsmedizin Berlin, Germany
  • Holger A. Haenssle Department of Dermatology, Venerology and Allergology, Georg August University, Göttingen, Germany

Keywords:

cutaneous melanoma, melanoma risk factors, early recognition, dermoscopy, confocal laser scanning microscopy

Abstract

Cutaneous melanoma is a highly aggressive malignant tumor of skin melanocytes with an increasing incidence in most countries of the world, especially in the fair-skinned populations. Despite all preventive and therapeutic efforts, malignant melanoma is still the most lethal skin cancer. A delayed diagnosis results in an advanced stage and worsened prognosis. Once distant metastases are present, the five-year survival rate is less than 10 percent. At the same time, patients may be cured by an early diagnosis of cutaneous melanoma followed by a wide excision. Therefore, the early detection of melanoma at curable stages is crucial for the patients’ survival. Besides the investigation of pigmented lesions with the unaided eye, a wide range of examination techniques for improved diagnostic accuracy have been developed and validated in clinical trials. However, none of these techniques are able to provide a definite and final diagnosis or to replace an excisional biopsy of suspicious lesions followed by histological analysis. This review provides a concise overview of general principles as well as current and future strategies for an improved early diagnosis of cutaneous melanoma.

References

1. Giblin AV, Thomas JM. Incidence, mortality and survival in cutaneous melanoma. J Plast Reconstr Aesthet Surg. 2007;60:32-40.

2. Haenssle HA, Korpas B, Hansen-Hagge C, et al. Selection of patients for long-term surveillance with digital dermoscopy by assessment of melanoma risk factors. Arch Dermatol. 2010;146:257-64.

3. Dulon M, Weichenthal M, Blettner M, et al. Sun exposure and number of nevi in 5- to 6-year-old European children. J Clin Epidemiol. 2002;55:1075-81.

4. Bauer J, Garbe C. Acquired melanocytic nevi as risk factor for melanoma development. A comprehensive review of epidemiological data. Pigment Cell Res .2003;16:297-306.

5. Friedman RJ, Gutkowicz-Krusin D, Farber MJ, et al. The diagnostic performance of expert dermoscopists vs a computer-vision system on small-diameter melanomas. Arch Dermatol. 2008;144:476-82.

6. Friedman RJ, Rigel DS, Kopf AW. Early detection of malignant melanoma: the role of physician examination and self-examination of the skin. CA Cancer J Clin. 1985;35:130-51.

7. Stolz W, Braun-Falco O, Bilek P, et al. Color atlas of dermatology. 2nd ed. Berlin: Blackwell Wissenschafts-Verlag, 2002.

8. Abbasi NR, Shaw HM, Rigel DS, et al. Early diagnosis of cutaneous melanoma: revisiting the ABCD criteria. JAMA. 2004;292:2771-6.

9. Grob JJ, Bonerandi JJ. The „ugly duckling” sign: identification of the common characteristics of nevi in an individual as a basis for melanoma screening. Arch Dermatol. 1998;134:103-4.

10. Scope A, Dusza SW, Halpern AC, et al. The “ugly duckling” sign: agreement between observers. Arch Dermatol. 2008;144:58-64.

11. Salerni G, Carrera C, Lovatto L, et al. Benefits of total body photography and digital dermatoscopy (“two-step method of digital follow-up”) in the early diagnosis of melanoma in patients at high risk for melanoma. J Am Acad Dermatol 2011 Jun 15. [Epub ahead of print]

12. Feit NE, Dusza SW, Marghoob AA. Melanomas detected with the aid of total cutaneous photography. Br J Dermatol. 2004;150:706-14.

13. Braun RP, Rabinovitz HS, Oliviero M, et al. Dermoscopy of pigmented skin lesions. J Am Acad Dermatol. 2005;52:109-21.

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Published

2012-07-31

Issue

Section

Review

How to Cite

1.
Brehmer F, Ulrich M, Haenssle HA. Strategies for early recognition of cutaneous melanoma—present and future. Dermatol Pract Concept. Published online July 31, 2012:29-37. doi:10.5826/dpc.0203a06

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