ABSTRACT
BACKGROUND: Breslow thickness, patient age and ulceration are the three most valuable clinical and pathological predictors of melanoma survival. A readily available reliable online tool that accurately considers these and other predictors could be valuable for clinicians managing melanoma patients. OBJECTIVE: To compare online melanoma survival prediction tools that request user input on clinical and pathological features. METHODS: Search engines were used to identify available predictive nomograms. For each, clinical and pathological predictors were compared. RESULTS: Three tools were identified. The American Joint Committee on Cancer tool inappropriately rated thin tumours as higher risk than intermediate tumours. The University of Louisville tool was found to have six shortcomings: a requirement for sentinel node biopsy, unavailable input of thin melanoma or patients over 70 years of age and less reliable hazard ratio calculations for age, ulceration and tumour thickness. The LifeMath.net tool was found to appropriately consider tumour thickness, ulceration, age, sex, site and tumour subtype in predicting survival. LIMITATIONS: The authors did not have access to the base data used to compile various prediction tools. CONCLUSION: The LifeMath.net prediction tool is the most reliable for clinicians in counselling patients with newly diagnosed primary cutaneous melanoma regarding their survival prospects.
Subject(s)
Melanoma , Skin Neoplasms , Humans , Aged , Aged, 80 and over , Melanoma/pathology , Skin Neoplasms/pathology , Prognosis , Sentinel Lymph Node Biopsy , Disease-Free SurvivalABSTRACT
A 32-year-old white man had a 5-month history of a progressively worsening rash on the dorsal aspect of his left foot. He stated that he engaged in self-tattooing of the left foot prior to the onset of the rash. Further questioning revealed that he had mowed the lawn wearing only sandals on the same day that he had tattooed his foot. The rash was diagnosed as lymphocutaneous sporotrichosis based on clinical appearance, biopsy examination, and fungal culture. Clearing of the lesions was documented following 4 months of therapy with itraconazole. The remaining granulomatous lesions were flattened with intralesional corticosteroid injections.
