May 08, 2014
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Previous dermatologic examination related to thinner, fewer invasive melanomas

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Patients with an established dermatologist experienced thinner and fewer invasive melanomas compared with patients who did not have a previous dermatologic examination in a recent study.

Laura K. Ferris, MD, PhD, assistant professor in the department of dermatology at the University of Pittsburgh School of Medicine, and colleagues conducted a retrospective, cross-sectional study of 388 patients (mean age, 54.6 years; 52.8% men) with primary melanoma diagnosed from February 2003 through December 2010.

laura ferris 

Laura K. Ferris

Patients with an established dermatologist (a previous dermatologic examination) had a greater likelihood of receiving a diagnosis of melanoma in situ (63.3%) compared with patients without an established dermatologist (44.5%; P=.001). Patients with established dermatologists also were more likely to have thinner invasive melanoma (0.48 mm [0.3-0.71 mm] vs. 0.6 mm [0.4-1.1 mm;]; P=.003).

Fifty-one percent of all melanomas were self-detected, along with 41.7% of in situ melanomas and 62.4% of invasive melanomas. In patients who had previously had a dermatologic examination, self-detected melanomas were in situ in 59% of cases, compared with 37% of patients without an established dermatologist (P=.006).

“Having an established dermatologist was associated with increased likelihood of being given a diagnosis of an in situ or thinner invasive melanoma, independent of the recency of the examination,” the researchers concluded. “This seems to be attributable to a higher rate of self-detection of thinner melanomas among individuals with a previous dermatologic examination.

“Our findings, in combination with data showing that a one-time skin cancer screening is cost-effective, highlight the value of having even a single dermatologic examination and suggest that educating patients to detect their own melanomas is an important part of improving early detection of melanoma.”

Disclosure: The researchers report no relevant financial disclosures.