Brown Marc D
Department of Dermatology, University of Rochester School of Medicine, Rochester, NY, USA.
Semin Cutan Med Surg. 2010 Dec;29(4):232-7. doi: 10.1016/j.sder.2010.10.001.
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.
随着黑色素瘤发病率持续上升，皮肤科医生作为这些患者的医学和外科肿瘤学家所发挥的作用也日益重要。皮肤科医生在护理的各个阶段都起着关键作用，包括预防、诊断、治疗和随访。皮肤科医生接受过全面而彻底的皮肤检查培训，最有能力在黑色素瘤生长的早期阶段识别它。皮肤科医生有独特的机会通过对患者进行适当的防晒、自我皮肤检查以及黑色素瘤识别要点（即不对称性、边界不规则、颜色变化、大小和演变）的教育来预防黑色素瘤。皮肤科医生接受过获取合适的全层皮肤活检的良好培训，并且有能力解读病理学家的报告并理解各种组织学预后指标的意义。大多数患者表现为局限性疾病，且Breslow深度较浅，因此皮肤科医生可以在门诊局部麻醉下熟练地对其进行治疗。
