Despite efforts to identify and cure early melanoma, mortality from this potentially curable disease continues to increase. In a retrospective analysis of the charts of 568 patients treated for superficial spreading melanomas during a ten-year period, the authors studied the relations between type of symptom, symptom duration, and thickness of the lesion. "Catalyst" symptoms, the particular events that preceded diagnosis, were identified. Patients described 75 different catalyst symptoms or symptom combinations. Bleeding precipitated prompt medical attention but was associated with the deepest lesions (mean thickness 1.77 mm); ulceration, itching and tenderness were associated with delays of several months and lesions of intermediate thickness (1.13 to 1.28 mm); and changes in size, color, or elevation eventuated in diagnosis an average of a year after patients' observations of these changes, with mean lesion thickness of .80 mm to 1.33 mm. Patients react slowly to signs and symptoms of early melanoma.

Female↗

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Curable melanomas: seek, and ye shall find.

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Humans↗

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MR imaging of intracranial metastatic melanoma.

Ten patients with intracerebral metastases from malignant melanoma were evaluated with magnetic resonance (MR) imaging performed at 1.5 T using spin-echo techniques. On the basis of histopathologic findings in three of 10 cases and CT appearances in all 10 cases, three patterns were identified on analysis of MR signal intensities in both short repetition time/echo time (TR/TE) and long TR/TE spin-echo scans. In comparison to normal cortex, nonhemorrhagic melanotic melanoma appeared markedly hyperintense on short TR/TE images and isointense, mildly hypointense on long TR/TE images. Nonhemorrhagic, amelanotic melanoma appeared isointense or mildly hypointense on short TR/TE and isointense or mildly hyperintense on long TR/TE images. Hemorrhagic melanoma varied in appearance, depending on the stage of hemorrhage. Melanotic, nonhemorrhagic melanoma can be distinguished from early and late subacute hemorrhage by its signal intensity on long TR/TE images. Spin-echo MR appears to be the method of choice for diagnosing melanotic metastases.

Brain Neoplasms↗

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Melanuria.

The urinary cytologic findings in a patient with metastatic malignant melanoma, diffuse melanosis and melanuria are presented. The melanosis was diagnosed from the clinical appearance of a generalized slate-blue skin discoloration, which is probably caused by dermal deposition of excess melanin pigment. The melanuria was characterized microscopically by the presence of amorphous, dark-brown casts, which stained positively for melanin pigment, and numerous pigment-laden macrophages.

Back Pain↗

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Skin markings in malignant melanoma.

Photographic analysis of the skin markings in 92 malignant melanomas (66 superficial spreading, seven nodular, 12 acral lentiginous, and seven lentigo maligna melanomas) was undertaken. Skin markings are uniformly eradicated in areas of vertical growth phase disease and sometimes in areas of regression. Not only were skin markings always preserved in areas of radical growth phase disease, but they were sometimes accentuated. For all types of melanoma, loss of skin markings is a poor diagnostic criterion because it is a late sign associated with invasion of the dermis and thus a deteriorating prognosis.

Humans↗

PubMedDate not supplied

Recognition and classification of clinically dysplastic nevi from photographs: a study of interobserver variation.

The recognition of dysplastic nevi from photographs can aid in population surveys of nevi and in epidemiological studies of melanoma risk. The reproducibility of techniques for recognizing nevi as dysplastic or for scoring them according to the degree of dysplasia has not been measured. Using photographs of 300 nevi taken in the course of a case-control study of melanoma, we assessed the agreement among six clinicians in independently categorizing nevi as dysplastic and in grading the degree of dysplasia. On average, reviewers agreed with each other 77% of the time in classifying a nevus as dysplastic or normal. Pairwise agreement within one point on a six-point scale occurred 87% of the time on average. These results suggest that criteria for recognizing nevi as clinically dysplastic from photographs can be applied reproducibility.

Analysis of Variance↗