Allan C. Halpern

Guest Editor for the following articles:

Jun
2009
Vol. 28. No. 2

Vitiligo Update

Johnathan L. Chappell, MD | Rebat M. Halder, MD

Vitiligo is an acquired dyschromia of the skin in which there is a loss of epidermal
melanocytes. The prevalence of vitiligo is approximately 1% in the United States and
0.1-2% worldwide. The exact pathogenesis of vitiligo remains elusive and is likely multifactorial.
After completing this update, participants should be able to discuss the epidemiology
of vitiligo and summarize the proposed mechanisms for development of this
disease. In addition, they should be able to discuss physical findings, approach to the
patient, and some of the therapeutic modalities for this disorder.
Semin Cutan Med Surg 28:86-92 © 2009 Elsevier Inc. All rights reserved.

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Mar
2008
Vol. 27. No. 1

Automated Diagnostic Instruments for Cutaneous Melanoma

Malene E. Vestergaard, MD | Scott W. Menzies, MB, BS, PhD

The objective of this review is to report and discuss the evidence for fully automated
diagnostic instruments for cutaneous melanoma tested in a real-world clinical setting
directly compared with human diagnosis. A systematic review was performed and articles
excluded when studies did not report sensitivity or specificity for melanoma directly
compared with humans on an independent test set. Only 3 instruments have had their
diagnostic accuracy compared with a human diagnosis in the clinical field with a meaningful
sample size that could allow some generalization with the wider clinical arena. Two
of these instruments showed a significantly inferior specificity for the diagnosis of melanoma
compared with specialists. In one of these studies, the sensitivity for diagnosis,
although superior to the specialist diagnosis, did not reach statistical significance. In
contrast, one instrument had an equivalent specificity and trended superior but not significantly
for sensitivity for the diagnosis of melanoma. Other image based nonclinic studies
and studies comparing clinical management as the endpoint rather than diagnosis are also
reviewed.
Semin Cutan Med Surg 27:32-36 © 2008 Elsevier Inc. All rights reserved.

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Jun
2009
Vol. 28. No. 2

Nonmelanoma Skin Cancer in Persons of Color

Brooke A. Jackson, MD

Skin cancer is the most common form of cancer in the United States. Although skin cancer
is less common in persons of color than in Caucasians, the rates of morbidity and mortality
associated with skin cancer often are significantly greater in darker-skinned ethnic groups.
This article reviews special considerations in the approach and management of nonmelanoma
skin cancer in patients of color.
Semin Cutan Med Surg 28:93-95 © 2009 Elsevier Inc. All rights reserved.

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Dec
2010
Vol. 29. No. 4

Office Management of Melanoma Patients

Marc D. Brown, MD

As the incidence of melanoma continues to increase, so does the role of the dermatologist as both medical and surgical oncologist for these patients. The dermatologist holds a key role in all phases of care, including prevention, diagnosis, treatment, and follow-up. The dermatologist is best trained to complete a full and thorough skin examination and is best able to recognize a melanoma in its early stages of growth. Dermatologists have a unique opportunity to prevent melanoma through appropriate patient education concerning sun protection, self skin examinations, and the ABCDEs of melanoma recognition (ie, asymmetry, border irregularity, color variations, dimension and evolution). The dermatologist is well trained to obtain an appropriate full-thickness skin biopsy and is knowledgeable to interpret the pathologist report and understand the significance of the various histologic prognostic indexes. Most patients present with localized disease and with thinner Breslow depth and thus can be skillfully treated in an outpatient setting under local anesthesia by
a dermatologist.
Semin Cutan Med Surg 29:232-237 © 2010 Published by Elsevier Inc.

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Jun
2009
Vol. 28. No. 2

Melanoma Arising in African-, Asian-, Latino- and Native-American Populations

Brenda A. Shoo, MD | Mohammed Kashani-Sabet, MD

This review highlights melanoma trends observed among African-, Asian-, Latino- and
Native-American populations. Melanoma is the most lethal form of skin cancer, accounting
for about 75% of all skin cancer deaths. Generally, incidence rates increase with age, peak
after age 40, and are greater in men than women. However, these trends do not reflect what
is typically seen in minority ethnic groups, where incidence rates are lower. In addition, for
some groups, relative disease-specific survival also is lower compared with European-
Americans. Melanomas in minority populations also tend to appear in atypical locations
and are of unclear etiology. To improve our understanding of the causes of melanoma
arising in ethnic minority populations future research efforts are needed. In addition, the
general lack of awareness of this disease entity among minority populations and the fact
that certain ethnic groups tend to present with advanced disease further highlight the need
for educational programs for both patients and health care professionals.
Semin Cutan Med Surg 28:96-102 © 2009 Elsevier Inc. All rights reserved.

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