key: cord-0762395-qaqn0uh3
authors: Schauer, A.A.; Kulakov, E.L.; Martyn‐Simmons, C.L.; Bunker, C.B.; Edmonds, E.
title: Melanoma defies ‘lockdown’: ongoing detection during Covid‐19 in central London
date: 2020-06-05
journal: Clin Exp Dermatol
DOI: 10.1111/ced.14324
sha: a52bd811474fdb126e1da8f79f077ac7e65fb0ab
doc_id: 762395
cord_uid: qaqn0uh3

The COVID‐19 pandemic has presented significant challenges for Dermatology services, particularly the diagnosis and management of malignant melanoma (MM). Early detection and definitive surgical treatment are key to improving MM prognosis, and in England there is a suspected skin cancer referral pathway that facilitates specialist Dermatology assessment within two weeks. Here, we describe the impact of COVID‐19 on MM detection, based on data from the a Dermatology Department in central London.

To the editor,

The COVID-19 pandemic has presented significant challenges for Dermatology services, particularly the diagnosis and management of malignant melanoma (MM). 1 Early detection and definitive surgical treatment are key to improving MM prognosis, and in England there is a suspected skin cancer referral pathway that facilitates specialist Dermatology assessment within two weeks. 2 Here, we describe the impact of COVID-19 on MM detection, based on data from the a Dermatology Department in central London.

This article is protected by copyright. All rights reserved A total number of 17 newly diagnosed, histologically confirmed cases of MM were identified; denoting eight and nine cases pre-and during 'lockdown', respectively. Most cases represented early or thin MM, including Mis (n = 7, 44%) and stage 1 melanoma (n = 7, 41%). MM detection rates were higher during 'lockdown' (5.73% vs 1.70%) of the total cases reviewed in the twoweek wait skin cancer clinic for each specified time period (n = 157 during, n = 481 before).

These findings highlight the importance of continued Dermatology cancer services during the UK COVID-19 'lockdown'; nine MM may not have been detected otherwise. The high proportion of early melanomas diagnosed exemplifies the efficacy of this rapid access skin cancer service. Not only was there ongoing MM detection, but a three-fold higher percentage detection rate demonstrated throughout the UK COVID-19 'lockdown'. There are a number of factors that may be implicated in this higher MM detection to referral ratio including patient self-selection in a setting of heightened anxiety and restricted health care services. Ongoing monitoring after 'lockdown' will be performed to explore whether there is a statistically significant difference between both referral and detection rates. This information may guide complex decision-making and demonstrates the necessity of MM skin cancer services, even in times of national emergency and gross disruption of normal medical services.

British Association of Dermatologists and British Society for Dermatological Surgery. COVID-19 -Skin cancer surgery guidance. Clinical Guidance for the Management of Skin Cancer