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Dermatologic surgeons' approaches to acral lentiginous melanoma: a survey of the American College of Mohs Surgery.
Isaq, Nasro A; Demer, Addison M; Vidal, Nahid Y; Lohman, Mary E.
Afiliación
  • Isaq NA; Department of Dermatology, Mayo Clinic School of Graduate Medical Education, Rochester, MN, USA.
  • Demer AM; Department of Dermatology, Division of Dermatologic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
  • Vidal NY; Department of Dermatology, Division of Dermatologic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
  • Lohman ME; Department of Dermatology, Division of Dermatologic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA. Lohman.mary@mayo.edu.
Arch Dermatol Res ; 316(1): 17, 2023 Dec 07.
Article en En | MEDLINE | ID: mdl-38059993
ABSTRACT
Acral lentiginous melanoma (ALM) is a subtype of melanoma that primarily affects ethnic minorities and is associated with poor outcomes. Racial inequalities in melanoma survival, particularly between Blacks and Whites, have been well documented in the literature. There are limited data on the role of surgical approach to ALM and its contribution to the existing disparities in ALM survival. Thus, this study aimed to investigate the role of surgical approach to ALM among Mohs surgeons. The survey was distributed to members of the American College of Mohs Surgery (ACMS), with 43 physicians completing the survey. The results showed that there was no consensus among Mohs surgeons regarding the surgical approach for ALM, even for advanced stages. 74% respondents performed complete circumferential peripheral and deep margin assessment (CCPDMA) for ALM, including Mohs micrographic surgery (MMS) or en face staged excision. However, barriers such as limited training, low comfort operating on acral sites, and inadequate access to specialized biopsies were reported. Treatment recommendations varied widely regardless of the ALM stage, with no significant differences based on exposure to ALM during training, practice setting, or percent of skin of color patients served. These findings highlight the lack of guidelines and the need for more data on outcomes to support optimal management of ALM. The study emphasizes the importance of addressing healthcare disparities and improving survival outcomes, particularly for ethnic minorities affected by ALM. Consensus guidelines could help standardize treatment approaches and potentially reduce disparities in ALM management.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 1_ASSA2030 Problema de salud: 1_acesso_equitativo_servicos Asunto principal: Neoplasias Cutáneas / Cirujanos / Melanoma Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Arch Dermatol Res Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 1_ASSA2030 Problema de salud: 1_acesso_equitativo_servicos Asunto principal: Neoplasias Cutáneas / Cirujanos / Melanoma Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Arch Dermatol Res Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos
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