Cutaneous melanoma in situ: A review

Karponis, Dimitrios, Joshy, Jilse, Stratigos, Ioannis A., Craig, Paul J., Mistry, Khaylen, van Bodegraven, Birgitta, Venables, Zoe C. and Levell, Nick J. (2025) Cutaneous melanoma in situ: A review. Clinical and Experimental Dermatology, 50 (3). pp. 529-536. ISSN 0307-6938

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Abstract

Cutaneous melanoma in situ (MIS), also known as ‘stage 0 melanoma’, is a collection of malignant melanocytes in the epidermis and epithelial adnexa, without evidence of microinvasion to the papillary dermis. Distinct histological subtypes include lentigo maligna (LM), superficial spreading (SS) MIS and acral lentiginous (AL) MIS. LM is the most common subtype, usually diagnosed later in life (median age at diagnosis of 66–72 years) and associated with cumulative ultraviolet radiation exposure. SS MIS is associated with intense episodes of sun exposure and is more common on the trunk and extremities. AL MIS is seen in nonhair-bearing skin. AL MIS, although rare (0.6% of MIS in England), is found in a higher proportion in more pigmented skin types compared with other MIS subtypes. Most international studies between 1990 and 2019 report rising incidence for MIS. US data show a decline in the incidence of LM between 2015 and 2019. For 2013–2019 in England, the recorded incidence of LM is plateauing, whereas that of other MIS is rising. Definitive diagnosis of MIS is by histological examination of biopsied skin with immunohistochemistry but can be supported with dermoscopy and reflectance confocal microscopy. Surgical treatment (excision or Mohs micrographic surgery) is the gold standard. Depending on MIS subtype, other options such as cryotherapy, topical imiquimod, radiotherapy or watchful waiting may be appropriate. The latest 5-year net-survival rates in England between 2013 and 2015 are 98.6% for AL MIS and exceed 100% for all other MIS. This review summarizes the aetiology, pathogenesis, epidemiology, diagnosis and management of MIS.

Item Type:	Article
Additional Information:	Publisher Copyright: © The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved.
Uncontrolled Keywords:	dermatology ,/dk/atira/pure/subjectarea/asjc/2700/2708
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Related URLs:	http://www.scopus.com/inward/record.url?...
Depositing User:	LivePure Connector
Date Deposited:	31 Mar 2025 15:30
Last Modified:	06 Apr 2025 06:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/98907
DOI:	10.1093/ced/llae465

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