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Melanoma: HELP
Articles by Alex John Chamberlain
Based on 5 articles published since 2009
(Why 5 articles?)

Between 2009 and 2019, Alex Chamberlain wrote the following 5 articles about Melanoma.
+ Citations + Abstracts
1 Guideline Clinical practice guidelines for the diagnosis and management of melanoma: melanomas that lack classical clinical features. 2017

Mar, Victoria J / Chamberlain, Alex J / Kelly, John W / Murray, William K / Thompson, John F. ·Victorian Melanoma Service, Alfred Health, Melbourne, VIC victoria.mar@monash.edu. · Victorian Melanoma Service, Alfred Health, Melbourne, VIC. · Peter MacCallum Cancer Centre, Melbourne, VIC. ·Med J Aust · Pubmed #29020893.

ABSTRACT: INTRODUCTION: A Cancer Council Australia multidisciplinary working group is currently revising and updating the 2008 evidence-based clinical practice guidelines for the management of cutaneous melanoma. While there have been many recent improvements in treatment options for metastatic melanoma, early diagnosis remains critical to reducing mortality from the disease. Improved awareness of the atypical presentations of this common malignancy is required to achieve this. A chapter of the new guidelines was therefore developed to aid recognition of atypical melanomas. Main recommendations: Because thick, life-threatening melanomas may lack the more classical ABCD (asymmetry, border irregularity, colour variegation, diameter > 6 mm) features of melanoma, a thorough history of the lesion with regard to change in morphology and growth over time is essential. Any lesion that is changing in morphology or growing over a period of more than one month should be excised or referred for prompt expert opinion. Changes in management as a result of the guidelines: These guidelines provide greater emphasis on improved recognition of the atypical presentations of melanoma, in particular nodular, desmoplastic and acral lentiginous subtypes, with particular awareness of hypomelanotic and amelanotic lesions.

2 Review Cutaneous melanoma--atypical variants and presentations. 2009

Chamberlain, Alex / Ng, Jonathan. ·Victorian Melanoma Service, The Alfred Hospital, Prahran, Victoria. alex_chamberlain@hotmail.com ·Aust Fam Physician · Pubmed #19575065.

ABSTRACT: BACKGROUND: The incidence of melanoma continues to rise in Australia. General practitioners treat the majority of skin cancers affecting Australians. In the past decade, there has been improved uptake of dermoscopy by GPs who realise its value in the assessment of pigmented and nonpigmented lesions. OBJECTIVE: This article outlines those variants or presentations of melanoma that create diagnostic difficulty for all clinicians. Practice tips regarding clinical features or useful dermoscopic clues are included. DISCUSSION: A clinical overview of lentigo maligna, acral lentiginous and subungual melanoma, nodular melanoma, desmoplastic melanoma, verrucous melanoma and hypomelanotic melanoma is presented. Dermoscopy has become a vital diagnostic aid in the assessment of all skin lesions. Its value in the diagnosis of melanoma is highlighted where relevant. Expert dermatopathology assessment is equally as crucial in reaching a correct diagnosis, especially for some of these atypical variants.

3 Clinical Trial Efficacy of imiquimod cream, 5%, for lentigo maligna after complete excision: a study of 43 patients. 2011

Ly, Lena / Kelly, John William / O'Keefe, Rodney / Sutton, Tina / Dowling, John P / Swain, Sarah / Byrne, Marguerite / Curr, Nathan / Wolfe, Rory / Chamberlain, Alex / Haskett, Martin. ·Victorian Melanoma Service, Level 1, Alfred Center, Alfred Health, Commercial Road, Melbourne, Victoria, Australia. lenaly21@yahoo.com.au ·Arch Dermatol · Pubmed #22006136.

ABSTRACT: OBJECTIVE: To determine the efficacy of imiquimod cream, 5%, in the treatment of lentigo maligna (LM). DESIGN: Open-label before-and-after interventional study. SETTING: A multidisciplinary melanoma clinic at a major tertiary hospital. PATIENTS: Forty-three patients with biopsy-proven LM of greater than 5 mm in diameter completed this study. INTERVENTIONS: Imiquimod cream, 5%, was applied to the lesion 5 days a week for 12 weeks. The original lesion was excised with a 5-mm margin. MAIN OUTCOME MEASURES: The primary outcome was histopathologic evidence of LM in the excision specimen assessed independently by 2 of 3 dermatopathologists. Visible inflammation during treatment and macroscopic clearance were recorded. RESULTS: When 5 of the 43 patients with discordant histopathologic assessment of the excision specimen were excluded, 20 of 38 patients (53% [95% confidence interval, 36%-69%]) demonstrated histopathologic clearance of LM after imiquimod treatment. Visible inflammation was significantly associated with histopathologic clearance (P = .04), but the positive predictive value was low (62%). Macroscopic clearance showed some association with histopathologic clearance (P = .11). Dermatopathologist concordance for all 43 specimens was substantial (κ = 0.77; 95% confidence interval, 0.57-0.96). CONCLUSIONS: Imiquimod cream, 5%, has limited efficacy in the treatment of LM when determined by histopathologic assessment of the entire treated area. The clinical signs of visible inflammation during treatment and apparent lesion clearance cannot be relied on to assess efficacy.

4 Article Methods of melanoma detection and of skin monitoring for individuals at high risk of melanoma: new Australian clinical practice. 2019

Adler, Nikki R / Kelly, John W / Guitera, Pascale / Menzies, Scott W / Chamberlain, Alex J / Fishburn, Paul / Button-Sloan, Alison E / Heal, Clinton / Soyer, H Peter / Thompson, John F. ·Victorian Melanoma Service, Alfred Hospital, Melbourne, VIC. · Armadale Dermatology, Melbourne, VIC. · Melanoma Institute Australia, Sydney, NSW. · University of Sydney, Sydney, NSW. · Royal Prince Alfred Hospital, Sydney, NSW. · Sydney Melanoma Diagnostic Centre, University of Sydney, Sydney, NSW. · Victorian Melanoma Service, Alfred Health, Melbourne, VIC. · Glenferrie Dermatology, Melbourne, VIC. · Norwest Skin Cancer Centre, Sydney, NSW. · Melanoma Patients Australia, Brisbane, QLD. · MelanomaWA, Perth, WA. · Dermatology Research Centre, Diamantina Institute, University of Queensland, Brisbane, QLD. · Princess Alexandra Hospital, Brisbane, QLD. ·Med J Aust · Pubmed #30636296.

ABSTRACT: INTRODUCTION: The evidence-based national clinical practice guidelines for the management of cutaneous melanoma published in 2008 are currently being updated. This article summarises the findings from multiple chapters of the guidelines on different methods of melanoma detection and of monitoring the skin for patients at high risk of melanoma. Early detection of melanoma is critical, as thinner tumours are associated with enhanced survival; therefore, strategies to improve early detection are important to reduce melanoma-related mortality. MAIN RECOMMENDATIONS: Clinicians who perform skin examinations for the purpose of detecting skin cancer should be trained in and use dermoscopy. The use of short term sequential digital dermoscopy imaging to detect melanomas that lack dermoscopic features of melanoma is recommended to assess individual melanocytic lesions of concern. The use of long term sequential digital dermoscopy imaging to detect melanomas that lack dermoscopic features of melanoma is recommended to assess individual or multiple melanocytic lesions for routine surveillance of high risk patients. The use of total body photography should be considered in managing patients at increased risk for melanoma, particularly those with high naevus counts and dysplastic naevi. There is insufficient evidence to recommend the routine use of automated instruments for the clinical diagnosis of primary melanoma. MANAGEMENT OVERVIEW: Determining the relative indications for each diagnostic method and how each method should be introduced into the surveillance of a patient requires careful consideration and an individualised approach.

5 Minor Photographic artefact simulating regressing melanocytic lesion: a potential pitfall of total body photography. 2012

Edwards, Sarah Prudence / Chamberlain, Alex John. · ·Australas J Dermatol · Pubmed #23157784.

ABSTRACT: -- No abstract --