Published in UAB Insight, Winter 2008
Early Detection Markedly Improves Prognosis
Melanoma is on the rise in the United States. The National Cancer Institute (NCI) estimates that in 2007 clinicians diagnosed more than 59,000 new cases and predicts 8000 of those patients will die of the disease. To combat growing numbers, UAB has launched a Pigmented Lesion Clinic focusing on detection and treatment of suspicious skin lesions.
“Melanoma, the most serious form of skin cancer, is increasingly prevalent in young adults,” says UAB Department of Dermatology Chair Craig A. Elmets, MD, who heads the clinic. “Other than surgical therapy, there is no effective treatment for the disease. This makes early detection crucial,” he says. The multidisciplinary clinic — the only Pigmented Lesion Clinic in Alabama — collaborates with surgical oncology, medical oncology, genetics, and other UAB specialties to provide comprehensive care to patients with melanoma.
Elmets notes the major etiology of melanoma is sun exposure, which makes the disease particularly prevalent in Alabama, as well as in Mississippi, Georgia, and Florida. “This clinic fills a much-needed niche in our region,” he says.
Other risk factors for melanoma are the presence of unusual moles, exposure to artificial ultraviolet rays, a family or personal history of skin cancer, age >20 years, light eyes, or red or blond hair. Although the disease can occur in people of all skin colors, it is most common among whites.
Indications of melanoma include moles with irregular edges that change in size, shape, or color; those that itch, ooze, bleed, or ulcerate; or those that are multicolored. Other indications are changes in skin pigment and growth of new moles near existing moles.
Clinic Services
Clinic staff provide patients with a thorough skin examination utilizing dermoscopy, a noninvasive technique for in vivo examination of pigmented lesions. “The procedure offers better visualization of surface and subsurface structures not visible to the naked eye, thereby enhancing dermatologists’ ability to distinguish between worrisome and ordinary pigmented skin lesions,” Elmets says.
The clinic also offers a mole mapping system to establish a baseline pattern of skin lesions. Photos and stored body maps of patient’s pigmented lesions allow dermatologists to evaluate changes over time. Images are stored electronically and dermatologists update and compare scans at each clinic visit.
To broaden UAB’s melanoma care program and advance innovative treatment and clinical trials, the clinic is developing a rich patient database that includes demographics, clinical features, histopathological findings, outcomes, participation in clinical trials, and links to patients’ mole maps and banked tissue of excised dysplastic nevi, melanomas, and other lesions. The clinic offers genetic counseling for individuals with a family history of melanoma or other risk factors for the disease.
“Early detection of melanoma saves lives,” Elmets says. “Individuals with a family or personal history of melanoma and those with unusual pigmented lesions should consider specialist evaluation.” The clinic is held once a week, and all patients require a physician referral.
For more information:
Dr. Craig Elmets
1.800.UAB.MIST
mist@uabmc.edu