Nausicaa Malissen, Safia Abed, Nicolas Macagno, Florent Amatore, Anderson Loundou, Florent Grange, Caroline Gaudy-Marqueste, Jean-Jacques Grob
DOI: 10.2340/00015555-3591

A Nodular Pink Lesion with an Uncommon Diagnosis: A QuizMost melanomas are diagnosed by the patients themselves or by their partners or relatives; they alone can describe its history. We designed a prospective cross-sectional study to describe patients’ perception of morphology, growth pattern and kinetics of their primary melanoma over 1 mm in thickness before resection. Patients were interviewed with a questionnaire, a grid representing 9 possible scenarios of melanoma growth, and a set of 87 photographs of potential aspects of melanomas and precursors. Most patients were able to describe the growth of their melanoma and select pictures representative of its successive aspects before resection. Among 453 patients, 60% reported a preexisting lesion present for years. Growth pattern scenarios concurred with tumor kinetics but with no statistical difference between nodular and superficial spreading subtypes. These subjective patient-reported indicators about melanoma growth over time could dynamically complement its objective pathological analysis otherwise static at a single time point.

Among 464 interviewed patients having undergone primary melanoma resection, most could describe precisely the kinetics and patterns of growth, as well as the features of their melanoma over time. Patient-reported “subjective” information is often neglected by clinicians. However, such information regarding melanoma kinetics of growth over time is probably indicative of biological aggressiveness. Any patient-described features indicative of a fast growing melanoma may constitute an additional argument favoring close follow-up, or even adjuvant treatment in ambiguous AJCC III A situations. Furthermore, better understanding of patients’ perception of early melanoma will help tailor the detection advice offered to the community.

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