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[Suspicious pigmented skin lesions. Screening campaign by occupational physicians in the Provence-Alpes-Côte d'Azur
E Virey-Griffaton1, M P Lehucher-Michel, S Hesse
1Service de médecine du travail, Hôpitaux de la Timone, 264, rue Saint-Pierre, 13385 Marseille.
Objective:
Cutaneous melanoma prevention has become a public health issue. The incidence of this cancer has been steadily growing for 50 years, and the related death ratio is not decreasing. Today, the surgical resection of a thin lesion is the only validated curative treatment. The early detection of melanoma represents a major line in the management of such tumours.
Methods:
Occupational physicians of the PACA area were invited to participate in a campaign for the screening of pigmented suspect cutaneous lesions for 2 years. Voluntary physicians were trained to use the ABCDEF diagnostic criterion. Lesions were detected during regular yearly consultations (1998/1999) and the data concerning the development and care of these lesions was collected during consultations over the following year (1999/2000).
Results:
Two hundred and fifty occupational physicians of the PACA area participated in the campaign. Two pre-cancerous lesions and 10 cancers (5 melanoma and 5 pigmented basocellular carcinoma) were found among the 487 suspect lesions detected. Each melanoma had a Breslow score of less than 0.9 mm and were of good or even excellent prognosis.
Conclusion:
The cutaneous examination, although rapid, during the occupational medicine consultations, is an effective means of detecting the early onset tumoral lesions which, at that stage may potentially be cured. The ABCDEF criterion is a useful diagnostic tool and should be taught to the all the medical and paramedical staff.