Melanoma in situ in a private practice setting 2005 through 2009: location, lesion size, lack of concern.
BACKGROUND
Studies have shown that the incidence of melanoma in situ (MIS) is increasing significantly.


OBJECTIVE
This study analyzes selected clinical and demographic characteristics of MIS cases observed in private dermatology practices in the United States.


METHODS
This study collected 257 MIS cases from 4 private dermatology practices in the United States from January 2005 through December 2009, recording age, gender, anatomic location, lesion size, patient-reported change in lesion, and concern about lesion. Case totals for invasive melanoma during the same period were recorded.


RESULTS
The data collected showed a higher incidence of MIS in sun-exposed areas of older patients, especially men. The median age of patients at the time of MIS detection was 69 years. The most common site for MIS was the head-neck region. The number of MIS cases collected exceeded the number of invasive malignant melanoma cases during the study period, with an observed ratio of 1.35:1.


CONCLUSIONS
For 136 patients, data were collected retrospectively for lesion size, location, gender, and age. For these patients, patient-reported change in lesion and concern about lesion were not collected. Patients often did not consent to a full body examination, therefore, it is possible that MIS lesions may have been missed in double-clothed areas.


CONCLUSIONS
Careful attention to pigmented lesions, even lesions less than 4 mm, on sun-exposed areas, including scalp, trunk, and feet, will facilitate earlier diagnosis of MIS. As only 30.4% of male patients and 50% of female patients had concern about these lesions, it still falls to the dermatologist to discover MIS.
University of Missouri-School of Medicine, Columbia, Missouri, USA.
Sherea M
SM
Stricklin
William V
WV
Stoecker
Joseph M
JM
Malters
Rhett
R
Drugge
Margaret
M
Oliviero
Harold S
HS
Rabinovitz
Lindall A
LA
Perry
D000328:Adult; D001294:Attitude to Health; D046169:Dermoscopy; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D011331:Private Practice; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D014481:United States / Q000453:epidemiology