Faculty Bibliography

In a consecutive series of 648 superficial spreading melanomas a significantly better 5-year disease-free survival rate was observed for patients whose primary tumors were 14 mm or less in diameter when compared with those 15 mm or larger in diameter. Other distinguishing features of the group of 'smaller' superficial spreading melanomas were that they occurred in younger patients; were of shorter durations; were more common in women; occurred disproportionately on the lower limbs; were less elevated; tended to be round in shape; were thinner (Breslow); penetrated less deeply (Clark levels); showed less histologic regression; and developed fewer metastases. Based on these findings it is recommended that educational programs be undertaken for the medical profession and for the public to promote early diagnosis and prompt treatment of superficial spreading melanomas when they are small in diameter and more often curable. A color atlas of 'small' melanomas is presented

An elderly patient with a large, acquired macular pigmented lesion on the skin of the left lateral canthus is described. Clinically, the lesion was consistent with lentigo maligna and total excision was performed. Histopathologic examination revealed atypically melanocytic proliferation at the dermal-epidermal junction without dermal invasion. The premalignant nature of this lesion is discussed as well as the clinical diagnostic clues. A brief review is given of the different types of cutaneous melanoma and prognostic factors, diagnosis, and management

Malignant melanomas sometimes occur simultaneously or subsequently in the skin and in the eye, multicentrically, not metastatically. The phenomenon is understandable in the B-K mole syndrome, in which multiple malignant melanomas are the rule. Otherwise simultaneous or subsequent malignant melanomas in one organ alone or in two disparate organs are rare and by change

A 51-year-old white man had the B-K mole syndrome (multiple large atypical cutaneous nevi of the upper part of the trunk and extremities, inherited as an autosomal dominant trait, and thought to be more susceptible to malignant transformation), so named after two patients in whom the syndrome was first observed. Two cutaneous malignant melanomas (thigh and back) and an ocular malignant melanoma (ciliary body and iris) simultaneously developed. Patients with B-K mole syndrome have been known to have a very high risk for the development of cutaneous melanoma (including multiple primary cutaneous melanomas) and multiple primary malignancies. There may be a propensity in these patients for development of ocular melanomas