The incidence and mortality rates associated with cutaneous melanoma (CM) have steadily increased over the last 20 years. Even with successful treatment, melanoma patients usually experience substantial anxiety regarding the development of terrible recurrence. This study investigates various dermatoses that caused anxiety in patients with CM during postoperative surveillance (Dw). Researchers performed a prospective study between August 2002 and August 2015. They found:
- 56 patients presented with a total of 68 Dw.
- Among them, melanocytic nevus was the most common (n=27), followed by seborrheic keratosis (n=9) and CM recurrence (n=7).
- Approximately 5.6% of the lesions were diagnosed as malignant skin diseases.
- This was a single-center study, so the prevalence of malignant skin diseases following primary melanoma may not represent that of all patients with CM.
Although this study illustrates the excessive or unrealistic anxiety patients with CM experience during postoperative surveillance, dermatologists should still stress the importance of postoperative surveillance due to the real risk of melanoma recurrence and other skin malignancies.
Lee H-J, Jin H, You H-S, et al. Various dermatoses what the patients with cutaneous melanoma had anxiety for the recurrence during postoperative surveillance. Ann Dermatol. 2017;29(4):433-437. doi:10.5021%2Fad.2017.29.4.433.
Patients with a history of melanoma understand the need for appropriate and consistent follow-up, in order to carefully observe for the occurrence of subsequent melanomas. Those with a past melanoma often have increased anxiety with the development of any new skin lesion. In my practice, I have had more than a few patients make emergency appointments because of the appearance of a lesion, which was subsequently diagnosed as a benign entity.
This study demonstrates that various skin conditions can cause anxiety in patients with a history of cutaneous melanoma during postoperative surveillance. Benign lesions which were identified included melanocytic nevi and seborrheic keratoses. The authors point out that dermatologists should still stress the need for close follow-up due to the risk of melanoma recurrence, even in the face of this anxiety.
—Jeffrey M. Weinberg, MD, FAAD
Assistant Clinical Professor of Dermatology, Columbia University College of Physicians and Surgeons, NYC
Director, Clinical Research Center/Dermatopharmacology, St. Luke's-Roosevelt Hospital Center, NYC
Acting Director, Division of Dermatology, Jamaica Hospital Medical Center, NYC