Clarification



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Am Fam Physician. 2001 Nov 15;64(10):1682-1685.

The article “Diagnosis and Management of Malignant Melanoma” (April 1, 2001, page 1359) requires some clarifications. The article states on page 1363 in the third line of the right-hand column that pruritus, ulceration and bleeding in a mole are common early warning symptoms of melanoma. This sentence should have been stated as follows: “Pruritus, ulceration and bleeding in a mole are warning symptoms.” Although pruritus may represent an early warning sign of melanoma, ulceration and bleeding tend to occur later in the course of disease and should not be relied on in making an early diagnosis of melanoma. Any suspicious or changing mole should be considered for early biopsy.

In the section on melanoma and pregnancy, on page 1367, the opening sentence of the final paragraph states that, until recently, women with a history of melanoma were discouraged from becoming pregnant for two years. Instead, that statement should read as follows: “Until recently, women with a history of melanoma were discouraged by physicians from becoming pregnant. Currently, women with a history of melanoma are counseled to avoid pregnancy for two years after diagnosis, because that is the period during which the risk of recurrence is greatest.” In the past, doctors discouraged women with a history of melanoma from ever becoming pregnant because of the possibility that estrogen would negatively affect melanoma prognosis. Currently, this restriction applies only to women who have had a melanoma with a significant probability of recurrence or metastasis.1

Table 1 on page 1360 contains an error. The heading for the second column should not include the percent sign since the values given represent relative risk. Also, the final paragraph on page 1360 refers the reader to Figure 1, which illustrates a small congenital nevus, while the text refers to giant congenital nevi.

The attributions for some of the figures were incorrect. Figures 1 and 7 were used with permission from the Department of Dermatology, University of North Carolina at Chapel Hill. Figure 4 was used with permission of John Cook, M.D., Aiken, S.C. Figure 6 was used with permission of the Department of Dermatology, Medical College of Georgia, Augusta. Figure 8 was used with permission from Goldstein BG, Goldstein AO. Practical dermatology. 2d ed. St. Louis: Mosby, 1997:146.

REFERENCE

1. MacKie RM. Pregnancy and exogenous female sex hormones in melanoma patients. In: Balch CM, Houghton AN, Sober AJ, Song S, eds. Cutaneous melanoma. 3d ed. St. Louis: Quality Medical, 1998:187–93.



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