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Journal of Skin Cancer
Volume 2012, Article ID 187963, 5 pages
Research Article

Comparing Melanoma Invasiveness in Dermatologist- versus Patient-Detected Lesions: A Retrospective Chart Review

1University of Nevada School of Medicine, Reno, NV 89557, USA
2Nevada Center for Dermatology, 650 Sierra Rose Drive, Suite A, Reno, NV 89511, USA
3University of California, Irvine, CA 92868, USA
4Center for Melanoma Research and Treatment, California Pacific Medical Center and CPMC Research Institute, San Francisco, CA 94143, USA

Received 10 May 2012; Revised 1 June 2012; Accepted 8 June 2012

Academic Editor: Giuseppe Argenziano

Copyright © 2012 Cindy L. Lamerson et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


This study examined whether patient-identified melanomas were more advanced than dermatologist-identified tumors at routine clinic visits, and whether a personal or family history of skin cancer was associated with patterns of detection. A retrospective chart review was performed on melanoma patients ( 𝑁 = 2 0 1 ) in a private dermatology clinic. Variables included age, gender, pattern of detection (i.e., patient or a board certified dermatologist), personal or family history of skin cancer, skin type, and previous sun exposure, as well as tumor location and severity. Dermatologist-diagnosed melanomas were less invasive ( 𝑃 < 0 . 0 0 0 5 ), and more likely present on the chest, back, and legs ( 𝑃 < 0 . 0 1 ). Conversely, patient-identified lesions were more likely to occur on the face, neck and scalp, be associated with younger patients, and a family history of melanoma, but not other types of skin cancer ( 𝑃 < 0 . 0 1 ). In a post-hoc analysis examining these factors as predictors of tumor invasiveness, only diagnostic source was significant. Specifically, dermatologist-identified tumors were significantly less invasive than patient-identified tumors. Although age, family history, and tumor location played roles in the early detection of melanomas, the most important factor was diagnostic source. Thus, board-certified dermatologists play a key role in the early detection of malignant melanoma.