A decade of melanomas: identification of factors associated with delayed detection in an academic group practice.

Background: Melanoma incidence is increasing, but the effect of various clinical factors on tumor stage is unclear.

Objective: To review histologic and clinical features of melanomas diagnosed in our group over a 10-year period to determine trends in diagnosis and lesion derivation, predictive value of clinical lesion size, and effect of physician and patient concerns before biopsy.

Method: Relevant pathology reports and physician clinic notes were reviewed for 572 melanomas.

Survivin enhances motility of melanoma cells by supporting Akt activation and {alpha}5 integrin upregulation.

Survivin expression in melanoma is inversely correlated with patient survival. Transgenic mice harboring melanocyte-specific overexpression of survivin exhibit increased susceptibility to UV-induced melanoma and metastatic progression. To understand the mechanistic basis for metastatic progression, we investigated the effects of survivin on the motility of human melanocytes and melanoma cells.

Low rates of clinical recurrence after biopsy of benign to moderately dysplastic melanocytic nevi.

Background: Little is known about the recurrence/persistence rates of dysplastic nevi (DN) after biopsy, and whether incompletely removed DN should be re-excised to prevent recurrence.

Objective: Our purpose was to determine the recurrence rates of previously biopsied DN, and to assess whether biopsy method, margin involvement, congenital features, epidermal location, and degree of dysplasia are associated with recurrence.

Methods: Patients having a history of a "nevus biopsy" at least 2 years earlier were assessed for clinical recurrence.

Use of oral N-acetylcysteine for protection of melanocytic nevi against UV-induced oxidative stress: towards a novel paradigm for melanoma chemoprevention.

Purpose: Induction of oxidative stress has been implicated in UV-induced melanoma. We sought to determine whether the antioxidant N-acetylcysteine (NAC) could be safely administered to protect melanocytic nevi from the oxidative stress resulting from acute UV exposure.

Experimental Design: Patients at increased risk for melanoma were recruited from a screening clinic.

Strategies for early melanoma detection: Approaches to the patient with nevi.

Unlabelled: Given its propensity to metastasize and the lack of effective therapies for most patients with advanced disease, early detection of melanoma is a clinical imperative. Although there are no noninvasive techniques for the definitive diagnosis of melanoma, and the "gold standard" remains biopsy with histologic examination, a variety of modalities may facilitate early melanoma diagnosis and the detection of new and changing nevi. This article reviews the general clinical principles of early melanoma detection and various modalities that are currently available or on the horizon, providing the clinician with an up to date understanding of management strategies for their patients with numerous or atypical nevi.