Imiquimod 5% cream as primary or adjuvant therapy for melanoma in situ, lentigo maligna type.

Background: Surgical resection of lentigo maligna (LM) is complicated by noncontiguous, subclinical extension and actinic melanocytic hyperplasia in sun-damaged skin of older individuals.

Objective: We sought to determine the long-term effectiveness of imiquimod as primary or adjuvant therapy for LM.

Methods: Patients were retrospectively identified from January 1, 2003, to December 31, 2013, with LM, early/evolving LM, and LM melanoma who had used topical imiquimod 5% cream for either primary therapy after diagnostic biopsy, or adjuvant therapy after narrow-margin surgical resection or complete clinical but not histologic resection of LM.

Focus on early detection to reduce melanoma deaths.

Thin fatal melanomas are a relatively new clinical and public health concern, representing an estimated 20% of melanoma deaths. Understanding this phenomenon will require a multi-pronged approach, including in-depth investigation of its behavioral and biological underpinnings. As we proceed with relevant studies, the benefits in lives saved will grow via early detection.

Tumor volume: an adjunct prognostic factor in cutaneous melanoma.

Measurement of tumor volume may be a helpful adjunct to established prognostic factors in cutaneous melanoma, including Breslow depth, presence or absence of ulceration, mitotic index, lymphovascular invasion, and microsatellites. This report expands on the theory that a tumor volume cutoff point of 250 mm³ as measured by surface area of the lesion (ie, longest vertical and horizontal measurements either based on clinical or gross pathological assessment) multiplied by the Breslow depth could serve as a potentially relevant predictor of sentinel lymph node (SLN) metastasis in both thin and thick invasive cutaneous melanomas, which prompted investigation of a larger sample size using the pathology database at our institution.

Involution of eruptive melanocytic nevi on combination BRAF and MEK inhibitor therapy.

Importance: Eruptive melanocytic nevi (EMN) are characterized by the sudden onset of numerous melanocytic nevi and have been traditionally described in the setting of immunosuppression. Selective BRAF inhibitors such as vemurafenib cause multiple cutaneous adverse effects, including the formation of cutaneous squamous cell carcinoma, as well as EMN. We describe the first reported case, to our knowledge, of involution of BRAF inhibitor-induced EMN following the concomitant addition of a MEK inhibitor, cobimetinib.

Behavioral determinants of successful early melanoma detection: role of self and physician skin examination.

Background: Reduced melanoma mortality should result from an improved understanding of modifiable factors related to early detection. The authors of this report surveyed newly diagnosed patients to identify differences in prediagnosis behavioral and medical care factors associated with thinner versus thicker melanoma.

Methods: In total, 566 adults with invasive melanoma completed questionnaires within 3 months of diagnosis on demographics, health care access, skin self-examination (SSE), and physician skin examination (PSE) practices in the year before diagnosis.

Examining the pathways linking lower socioeconomic status and advanced melanoma.

Background: Low socioeconomic status (SES) is associated with more advanced melanoma at diagnosis and decreased survival. Exploring the pathways linking lower SES and thicker melanoma will help guide public and professional strategies to reduce deaths.

Methods: The authors surveyed 566 newly diagnosed patients at Stanford University Medical Center, Veterans Affairs Palo Alto Health Care System, and University of Michigan.