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Invited Commentary |

Role of Sildenafil in Melanoma Incidence and Mortality

June K. Robinson, MD1,2
[+] Author Affiliations
1Editor, JAMA Dermatology
2Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
JAMA Intern Med. 2014;174(6):970-971. doi:10.1001/jamainternmed.2014.157.
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In 2014, about 76 100 new melanomas will be diagnosed, and an estimated 9710 persons will die (about 6470 men and 3240 women).1 Patients with melanoma in situ, stage 0, have a 5-year survival rate of 99% when treated with excision, whereas those with melanoma limited to the skin and with a tumor thickness of 2.01 to 4.0 mm, stage II B, have a 5-year survival rate of about 57%. Patients with metastatic melanoma, stage IV, have a 5-year survival rate of 15% to 20%. Despite newly available targeted agents, systemic therapies rarely lead to cures. These sizable survival differences illustrate the need for early detection of melanoma; early detection of primary melanomas followed by surgical excision remains critical.

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Clinical Features of Melanoma

A, Macular pigmented lesion on the cheek of a man in his 80s demonstrates a diameter larger than 6 mm, a variety of tan-brown colors, and an irregular border. B, Clinically visible border traced on the image by the author demonstrates the irregular border and helps highlight the range of colors. Adapted from Guitera et al.8 C, Clinically concerning nodular melanoma is a shiny papule with irregular borders, a hint of brown and gray at the top edge, and a 5-mm diameter. Adapted from Kalkhoran et al.9

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