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Melanoma In Situ

  • Charles Thomas Darragh
  • Anna S. Clayton
Chapter

Abstract

Melanoma in situ (MIS) is defined as a malignant melanocytic tumor restricted to the epidermis. According to recent database statistics, it is the fastest-growing cancer in the United States with a 9.5% annual incidence increase. Melanoma in situ is not a dangerous tumor and is classified as stage 0. Patients diagnosed with MIS have the same life expectancy as the general population. It is important to remember the ABCDEs of melanoma when evaluating for lesions suspicious of melanoma in situ. There are several clinical subtypes, most notably lentigo maligna, which is found on sun-damaged sites. Diagnosis of MIS is made with histopathology, often with accompanying immunohistochemical stains including SOX 10 and Melan-A. It can be very difficult to determine severely sun-damaged skin versus MIS lesions under the microscope, and this remains a challenge for dermatopathologists. Once a diagnosis of MIS is made, it can be treated with several surgical options. These options include wide local excision, Mohs micrographic surgery, and staged excision or “slow Mohs.” In certain circumstances, imiquimod or radiation could be considered for adjuvant therapy. After diagnosis of MIS, patients should be followed closely with every 3- to 6-month skin checks.

Keywords

Melanoma in situ ABCDEs Lentigo maligna Mohs micrographic surgery Wide local excision Staged excision Imiquimod Dermoscopy Sox 10 Dermatopathology 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Dermatology, Vanderbilt University of MedicineNashvilleUSA

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