title: Melanoma depth in patients with an established dermatologist.
abstract: BACKGROUND
  The impact of having an established dermatologist on melanoma depth at diagnosis is incompletely understood.
  
  
  OBJECTIVE
  We sought to determine whether having had a previous dermatologic examination (an established dermatologist), the recency of the last examination, and the wait time for the dermatology appointment are associated with melanoma invasiveness and depth.
  
  
  METHODS
  This was a retrospective cross-sectional study of 388 patients with primary melanoma at an academic dermatology department.
  
  
  RESULTS
  Patients with an established dermatologist were more likely than patients without an established dermatologist to be given a diagnosis of melanoma in situ (103/162 [63.6%] vs 69/155 [44.5%], P = .001) and to have thinner invasive melanoma (0.48 [0.30-0.71] mm vs 0.61 [0.40-1.10] mm, respectively, P = .003). These trends were observed for patients with self-detected, but not dermatologist-detected, melanoma. Patient-detected melanomas made up 184/361 (51.0%) of all melanomas, 83/199 (41.7%) of in situ melanomas, and 101/162 (62.4%) invasive melanomas. Self-detected melanomas were in situ in 36 of 61 (59.0%) patients with an established dermatologist versus 40 of 108 (37.0%) patients without an established dermatologist, P = .006. Neither time from last dermatologic examination nor wait time for an appointment was associated with melanoma invasiveness or depth.
  
  
  CONCLUSIONS
  Data are retrospective and from 1 large academic health care system.
  
  
  CONCLUSIONS
  Education obtained at the dermatology appointment may improve early self-detection of melanoma, and having an established dermatologist may facilitate earlier evaluation of concerning lesions.
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Michelle Y
authors.initials: MY
authors.lastname: Cheng
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Jacqueline F
authors.initials: JF
authors.lastname: Moreau
authors.affiliation: Department of Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Sean T
authors.initials: ST
authors.lastname: McGuire
authors.affiliation: Department of Dermatology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Jonhan
authors.initials: J
authors.lastname: Ho
authors.affiliation: Department of Dermatology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Electronic address: ferrlk@upmc.edu.
authors.forename: Laura K
authors.initials: LK
authors.lastname: Ferris
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010817:Physician-Patient Relations; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis / Q000473:pathology*; D014850:Waiting Lists
keywords: dermatology; education; melanoma; prevention; public health; skin cancer