title: Self-detection frequency and recognition patterns in medium to high-risk cutaneous melanoma patients.
abstract: OBJECTIVE
  The question of how frequently patients with medium to high-risk melanomas become aware of their tumors and which self-detection patterns exist remains unanswered.
  
  
  METHODS
  We conducted a retrospective survey of melanoma patients who had undergone sentinel node biopsy between 2004 and 2008. One hundred twenty-seven out of a total of 133 patients completed the questionnaire.
  
  
  RESULTS
  Twenty-five percent of patients had not noticed their tumors at all. The remaining 75 % showed three different self-detection patterns, with 25 % of individuals seeking medical advice within 0-12 weeks and another 25 % within 3-6 months. The remaining 25 % had waited for more than six months prior to tumor excision. Age, gender, and melanoma location were comparable in all self-detection subgroups. The most frequent subtypes were: SSM (59), NMM (31), ALM (9), UCM (9) and LMM (4). Rare subtypes occurred in 15 individuals. Patients with lesions previously noticed for 3-6 months revealed the highest average tumor thickness and the significantly highest number of pT4 tumors. Sixty percent of NMM patients had a disease history < 6 months. Rare subtypes such as amelanotic, spindle cell, or spitzoid melanoma were self-detected in only 50 % of cases.
  
  
  CONCLUSIONS
  Even advanced melanoma lesions remained undetected in 25 % of patients; rare melanoma subtypes, in 50 % of cases. Thus, self-examination frequency, increased awareness of rare melanoma subtypes, and rapid referral to a specialist ought to be at the center of future awareness campaigns.
authors.affiliation: Department of Dermatology and Allergology, University of Ulm, Germany.
authors.forename: Anca
authors.initials: A
authors.lastname: Sindrilaru
authors.affiliation: Department of Dermatology and Allergology, University of Ulm, Germany.
authors.forename: Vera
authors.initials: V
authors.lastname: Neckermann
authors.affiliation: Department of Dermatology and Allergology, University of Ulm, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Eigentler
authors.affiliation: Department of Dermatology and Allergology, University of Ulm, Germany.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kampilafkos
authors.affiliation: Department of Dermatology and Allergology, University of Ulm, Germany.
authors.forename: Diana
authors.initials: D
authors.lastname: Crisan
authors.affiliation: Department of Dermatology and Allergology, University of Ulm, Germany.
authors.forename: Nicolai
authors.initials: N
authors.lastname: Treiber
authors.affiliation: Department of Dermatology and Allergology, University of Ulm, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Scharffetter-Kochanek
authors.affiliation: Department of Dermatology and Allergology, University of Ulm, Germany.
authors.forename: Lars Alexander
authors.initials: LA
authors.lastname: Schneider
mesh_terms: D000328:Adult; D000368:Aged; D049109:Cell Proliferation; D057210:Delayed Diagnosis; D059026:Diagnostic Self Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000145:classification / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000473:pathology; D011795:Surveys and Questionnaires
keywords: Melanoma; carcinogenesis; epidemiology; proliferation; tumor progression