title: Patterns of detection of superficial spreading and nodular-type melanoma: a multicenter Italian study.
abstract: BACKGROUND
  Nodular histotype represents the condition that is mostly associated with diagnosis of thick melanoma.
  
  
  OBJECTIVE
  The objectives were to evaluate variables associated with and pattern of detection of nodular melanomas and to investigate variables associated with early diagnosis in accordance with histotype (nodular vs. superficial spreading melanomas).
  
  
  METHODS
  From the original data set of 816 melanomas, all the invasive lesions classified as superficial spreading (n=500) and nodular (n=93) melanomas were considered for the study. A multivariate logistic analysis was performed. Results. Nodular melanomas did not significantly differ from superficial spreading melanomas regarding sex, anatomic site, number of whole-body nevi, and the presence of atypical nevi. As expected, nodular melanomas were represented by a higher percentage of thick (>2 mm) lesions compared to superficial spreading melanomas (64.5% vs. 9.6%, p<0.001). The pattern of detection significantly differed between nodular and superficial spreading melanomas, the former being more frequently self-detected (44.1% vs. 38.0%) or detected by the family doctor (34.4% vs. 11.4%). Female sex, high level of education, and detection made by a dermatologist had an independent, protective effect against late (>1 mm in thickness) diagnosis in superficial spreading melanomas. No protective variable associated with nodular melanomas was found.
  
  
  CONCLUSIONS
  Patterns of detection for nodular melanomas significantly differ from those for superficial spreading melanomas. For superficial spreading, but not for nodular, melanomas, variables associated with protective effect against late diagnosis can be identified.
authors.affiliation: Department of Dermatology, University of Florence, Florence, Italy. CARLI@unifi.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Carli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Giorgi
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Andrea
authors.initials: A
authors.lastname: Maurichi
authors.forename: Patrizio
authors.initials: P
authors.lastname: Mulas
authors.forename: Catiuscia
authors.initials: C
authors.lastname: Orlandi
authors.forename: Gianlorenzo
authors.initials: G
authors.lastname: Imberti
authors.forename: Ignazio
authors.initials: I
authors.lastname: Stanganelli
authors.forename: Pierfranco
authors.initials: P
authors.lastname: Soma
authors.forename: Domenico
authors.initials: D
authors.lastname: Dioguardi
authors.forename: Caterina
authors.initials: C
authors.lastname: Catricalá
authors.forename: Roberto
authors.initials: R
authors.lastname: Betti
authors.forename: Simone
authors.initials: S
authors.lastname: Paoli
authors.forename: Ugo
authors.initials: U
authors.lastname: Bottoni
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lo Scocco
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Scalvenzi
authors.forename: Benvenuto
authors.initials: B
authors.lastname: Giannotti
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D008875:Middle Aged; D012042:Registries; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D011795:Surveys and Questionnaires