< Current issue
Dermatopathology: Practical & Conceptual July - September 2001
Evolution in Thinking: Criteria for Clinical Diagnosis of Melanoma, 1947–2000: A Critique in Historical Perspective
Mary Aldrene L. Tan, M.D.
A. Bernard Ackerman, M.D.
Becker and Obermayer
Ormsby and Montgomery
Sulzberger and Wolf
Pillsbury, Shelley, and Kligman
Fitzpatrick and Clark
Lewis and Wheeler
Callen, Stawiski, and Voorhees
Roses, Harris, and Ackerman
Dobson and Abele
Friedman, Rigel, and Kopf
Fitzpatrick, Rhodes, Sober, and Mihm
Koh and Rogers
McCarthy et al.
Mooi WJ and Krausy
Fitzpatrick, Milton, Balch, Shaw, McCarthy, and Sober
National Institutes of Health Consensus Conference
Holzle, Kind, Plewig, and Burgdorf
Marghoob, Slade, Kopf, Rigel, and Friedman
Arndt, Wintroub, Robinson, and LeBoit
Elder and Elenitsas
Maize et al.
Langley, Fitzpatrick, and Sober
Farmer and Hood
Fleischer, Feldman, Katz, and Clayton
Ackerman, Kerl, Sánchez, et al.
"Malignant melanomas are presented in a multiplicity of disguises, and their appearance may vary from that of exuberant granulation tissue (as is seen with subungual malignant melanomas) to that of other skin tumors, including dermatofibromata, hemangiomata, basal and squamous cell carcinomata and atypical fibroxanthomas. In those lesions in which melanin pigmentation is obvious, the size may vary from a macule less than 5 mm. in diameter to an enormous, fungating, ulcerated lesion surrounded by satellites . . ."
" . . . Rapid growth, excessive pigmentation, ulceration, hemorrhage, or local infiltration—any of these changes occurring within a pigmented nevus warrants a clinical diagnosis of malignant melanoma until histologically proven otherwise."
Wayte DM. Pathology of Nevi and Melanomas. In: Helwig EB, Mostofi FK, eds.
The Skin by 30 authors.
Baltimore: Williams and Wilkins, 1971:521.
By the time that a melanoma simulates "exuberant granulation tissue . . . dermatofibromata, hemangiomata, basal and squamous-cell carcinomata, and atypical fibroxanthomas," almost certainly it has already metastasized. What needs to be emphasized in regard to cure of melanoma is recognition of it as a "macule less than 5 mm in diameter" and not as an "enormous, fungating, ulcerated lesions surrounded by satellites . . ." By the time, too, that there is "rapid growth," ulceration, and hemorrhage of melanoma, the neoplasm is many years old and, almost certainly, has spread through vascular channels to other sites.
This site is made possible in part by:
Copyright © Derm101.com. All Rights Reserved.