A Case Presentation of Three Polypoid Melanomas With Divergent Features.

Polypoid melanoma, a subtype of nodular melanoma, is classified as the most aggressive and deadly form of cutaneous melanoma. Its rapid vertical growth phase and a wide array of divergent features make clinical diagnosis extremely difficult. This report includes three cases of polypoid melanoma that were all originally thought to be other benign lesions or non-melanoma cancer. These cases feature the variability of the clinical presentation of polypoid melanomas while emphasizing the importance of an annual skin examination, complete lesion biopsies, and working with experienced dermatopathologists for the correct diagnosis and prompt treatment of these cancers. By sharing these cases and general information on polypoid melanoma, we aim to spread awareness of this rarer subtype of melanoma and highlight the importance of having a broad differential list when presented with suspicious lesions.

The relationship between neighborhood typologies and self-rated health in Maryland: A latent class analysis.

Despite widespread evidence that neighborhood conditions impact health, few studies apply theory to clarify the physical and social factors in communities that drive health outcomes. Latent class analysis (LCA) addresses such gaps by identifying distinct neighborhood typologies and the joint influence that neighborhood-level factors play in health promotion. In the current study, we conducted a theory-driven investigation to describe Maryland neighborhood typologies and examined differences in area-level self-rated poor mental and physical health across typologies. We conducted an LCA of Maryland census tracts (n = 1384) using 21 indicators of physical and social characteristics. We estimated differences in tract-level self-rated physical and mental health across neighborhood typologies using global Wald tests and pairwise comparisons. Five neighborhood classes emerged: Suburban Resourced (n = 410, 29.6%), Rural Resourced (n = 313, 22.6%), Urban Underserved (n = 283, 20.4%), Urban Transient (n = 226, 16.3%), Rural Health Shortage (n = 152, 11.0%). Prevalence of self-rated poor physical and mental health varied significantly (p < 0.0001) by neighborhood typology, with the Suburban Resourced neighborhood class demonstrating the lowest prevalence of poor health and the Urban Underserved neighborhoods demonstrating the poorest health. Our results highlight the complexity of defining "healthy" neighborhoods and areas of focus to mitigate community-level health disparities to achieve health equity.