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From the Archives Journals |

The Duty to Inspect the Skin and Counsel Those at Risk to Develop Melanoma

June K. Robinson, MD; Kimberly A. Mallett, PhD
JAMA. 2009;301(16):1702-1704. doi:10.1001/jama.2009.542.
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Melanoma prognosis is directly related to stage at diagnosis with mortality directly related to the Breslow thickness of the primary lesion.1 Early detection and surgical excision of melanoma in a curable stage is the most effective method to decrease mortality, which has remained relatively stable in recent years. Decreased survival is associated with later stage at the time of diagnosis, nodular or acral lentiginous histology, increased age, male sex, nonwhite race, and lower income.13 In the United States, an estimated 62 480 individuals were expected to develop melanoma in 2008, which means 1 in 52 men and 1 in 77 women will develop this potentially lethal cancer during their lifetime.4 Which patients would benefit from physician surveillance? Who are the patients that may benefit from physicians' recommendations to perform skin self-examination? Should physicians encourage patients to request assistance from their partners with skin self-examination?

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