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Report of a Survey in Occupational Medicine

Philippe Guibert, MD; François Mollat, MD; Marc Ligen, MD; Brigitte Dreno, PhD

Arch Dermatol. 2000;136:199-202.

Background  Epidemiological studies concerning melanoma are most often performed by general practitioners and dermatologists in patients previously aware of the risk of nevi.

Objective  To determine the efficiency of early detection of melanoma by occupational medicine specialists trained in the use of ABCDE criteria during annual systematic examination of workers.

Methods  A total of 370 subjects with suspect lesions that demonstrated at least 2 of 5 ABCDE criteria were selected from 65,000 employees examined; these subjects were requested to see their physician about possible excision. Of the 370 subjects, 273 (73.8%) were seen at a second-year follow-up visit to determine their outcome.

Results  Among the 273 subjects who were seen again, 172 (63.0%) had consulted a physician. For the 101 subjects who had not seen a physician, the main reason was the negligence (86.1%). A total of 353 atypical nevi were observed. The mean number of ABCDE criteria noted per lesion was 2.6. Lesion diameter greater than 6 mm was the most frequent (80.5%) and enlargement the least frequent criteria seen; heterochromous coloration and diameter greater than 6 mm was the most common association (54.5%). Five histologically confirmed melanomas were found among nevi excised in 78 subjects.

Conclusion  This screening approach seems efficient for the early detection of melanoma, demonstrating an incidence of 7.7 per 100,000 vs 9 per 100,000 in the general French population.

From Interne-Clinique Dermatologique du Centre Hospitalo-Universitaire (CHU) de Nantes (Dr Guibert), Association d'Hygiène Industrielle et de Médecine du Travail de la région Nantaise (Drs Mollat and Ligen), and Clinique Dermatologique CHU Nantes (Dr Dreno), Nantes, France.

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