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Melanoma

Melanoma is the most serious type of skin cancer due to its potential to metastasize to other body organs. People can die from melanoma but melanoma can also be cured by surgery alone if caught early. The incidence of melanoma in the United States has been increasing. Melanoma results from changes within the pigment producing cells called melanocytes. It can occur on its own or within a pre-existing mole. A melanoma can develop on any part of the skin even those areas not commonly exposed to the sun. It can also develop within the eye. The risk of developing melanoma increases with age but it is also the most common cancer in woman aged 25 to 29. It is rare before puberty. There are different types of melanoma: superficial spreading, nodular, lentigo maligna, and acral lentiginous. Up to 70% of melanomas fall into the category of superficial spreading melanoma. It is commonly found on the backs of men and on the legs of women. It appears as a flat to slightly raised irregularly shaped and colored spot. It is slow growing often over a period of years. Nodular melanomas are the next most common. They represent 15% to 30% of melanomas and involve deeper layers of the skin. They are rapidly growing over a period of months and occur as a brown, black, blue or non-pigmented raised lesion. Lentigo maligna melanoma represents 4% to 10% of melanomas. Lentigo maligna occurs on sun exposed areas, particularly the face, of older individuals. It is characterized by an irregularly shaped and irregularly colored flat spot. The least common type of melanoma is the acral lentiginous variety, which represents 2% to 8% of melanomas. This type occurs on the palms and soles and is most commonly seen in black individuals. Acral melanomas can also occur on the bed of the fingernail or toenail and is characterized by a dark streak within the nail.

Diagnosis

Melanomas are diagnosed with a skin biopsy. Melanomas are staged based upon the size of the tumor, whether or not lymph nodes are involved and whether or not the cancer has metastasized. The thickness of the lesion and whether or not ulceration is present are also important factors in determining the severity of the melanoma and prognosis. During skin exams a trained professional will employ the ABCDs of melanoma when evaluating a lesion. These include "A" for asymmetry, "B" for borders (looking for jagged or irregular borders), "C" for color (looking for a mixture of brown, black, red or a lesion that looks significantly different in color than a patient's other moles) and "D" for diameter (anything 6 mm or larger will draw attention but may not indicate concern if none of the other features are present). If a lesion has any suspicious features a biopsy should be performed. After microscopic evaluation by a pathologist the diagnosis can be made.

Treatment

Melanoma is treated through surgery. The entire lesion needs to be excised with a margin of normal tissue to ensure definitive removal. The width of the safety margin needed is determined by the depth of the melanoma. For thicker melanomas a sentinel lymph node biopsy (SLNB) may be done to check to see if the cancer has spread to the lymphatic system.

Management

It is recommended that an individual who has been diagnosed with a melanoma have a complete skin exam every 3 months for the first 1-3 years. After this period skin exams should be performed every 6 months. During these exams that entire skin surface should be evaluated because melanomas can occur in non sun exposed areas. The exam will look for evidence of recurrent or metastatic lesions as well as precursor lesions. All immediate family members should also have an annual complete skin examination.

Coping

Patients who have received a diagnosis of melanoma can receive support through organizations such as the American Melanoma Foundation (www.melanomafoundation.org). They should also check their skin periodically themselves for new or changing lesions and comply with recommendations for a professional skin check.

Prevention

Prevention of melanoma and skin cancers in general can be facilitated by strict sun protection through daily appropriate use of sunscreen and sun protective clothing. Regular skin checks by a trained professional will also help identify skin cancers and potential precursor lesions.

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SKIN

# of surveys: 3749
Last updated: 05/18/2017 4:45 PM,

PATIENT RATINGS

Would you recommend us?

definitely
93.1%
probably
6.16%
maybe
0.58%
not likely
0.08%
no
0.02%

Compare our service to other similar practices

excellent
87.9%
very good
10.1%
good
1.8%
poor
0.06%
very poor
0%

Overall doctor performance

excellent
94.2%
very good
4.89%
good
0.80%
poor
0.03%
very poor
0%

The doctor listened to you attentively

excellent
93.9%
very good
4.97%
good
1.05%
poor
0.05%
very poor
0%

The doctor took time to answer your questions

excellent
94.0%
very good
4.66%
good
1.27%
poor
0.02%
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0%

The doctor explained treatment options

excellent
94.3%
very good
4.16%
good
1.25%
poor
0.14%
very poor
0.02%

The doctor explained treatment options

excellent
92.0%
very good
5.69%
good
2.18%
poor
0.11%
very poor
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Front desk performance

excellent
85.6%
very good
10.2%
good
3.66%
poor
0.31%
very poor
0.08%

Aesthetician performance

excellent
88.6%
very good
7.61%
good
3.39%
poor
0.24%
very poor
0.08%

Office comfort

excellent
90.9%
very good
6.93%
good
2.08%
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0.05%
very poor
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Parking

excellent
66.4%
very good
14.4%
good
15.7%
poor
2.49%
very poor
0.9%

Friendliness of the staff during appointment

excellent
90.9%
very good
7.23%
good
1.85%
poor
0.05%
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What WE DID WELL

(Answers:674)

Seeing Dr. Ringpfeil again!

#12017-02-24

The knowledge, helpfulness, and friendliness of every person in this office has made me decide to have my daughter and me be seen here instead of by a doctor in the area in which we live (more than half an hour away). Thank you.

#22017-06-29

Dr. Ringpfeil has a great bedside manner and is very patient. Loved the art work!

#32011-04-11 16:33:05

The care, attention and kindness were remarable--thank you!

#42018-01-06

Staff was very friendly. The office is beautiful, organized, and very clean. I am very happy with my choice to see Dr. Ringpfeil!

#52018-02-17

I liked the modern office look, and how the doctor was very friendly and listened to everything I said.

#62017-04-24

Everyone was knowledgeable and comfortable... clean, efficient, great!

#72011-04-18 09:46:06

Clean, bright, well appointed office

#82017-09-12

every thing was great.

#92017-12-05

everything is very thorough and comprehensive

#102011-11-02 11:42:46

What can we do better?

(answers:373)

No complaints - overall best experience at any dermatologist.

#12011-09-27 12:59:17

no complaints. everything was fine.

#22017-05-05

No room for improvement

#32017-09-17

Nothing!

#42017-07-26

Just keep up the good work!

#52017-11-25

Being able to get an appointment at the time of the outbreak.

#62017-04-12

I thought everyone was fantastic and very helpful-no suggestions had a great experience

#72017-10-15

Overall excellent service. Friendly front desk staff. A very small suggestion would be to have someone immediately identify themselves as the person to register a new patient and direct where to go when someone enters the waiting room. With a big waiting room and three people at the front desk, it is a lot to take in and not know to whom to speak. Having had negative experiences with doctors' receptionists where all three of the three people at the front desk have ignored me until I called out and forced a response, I am sensitive to the issue and imagine others have had this experience as well.

#82011-01-31 10:42:48

Magazines in the examining room to read while I waited for the doctor (I get bored easily).

#92017-03-09

Everything was great.

#102017-07-29
Customer Rating : 4.1

Based on 36 ratings