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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: 3750
Last updated: 05/25/2018 9:32 AM,

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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The doctor explained treatment options

excellent
94.3%
very good
4.16%
good
1.25%
poor
0.14%
very poor
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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
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very poor
0.08%

Office comfort

excellent
90.9%
very good
6.93%
good
2.08%
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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)

I came here because my previous doctor's staff was not friendly or helpful. I am very glad I switched. Everyone here has been very nice and professional

#12018-09-30

aNDREA AND DR RINGFEIL WERE ABS0LUTELY TERRIFIC AND VERY FRIENDLY

#22018-11-02

Climate and environment

#32018-12-28

The general friendliness, and knowledgeability of the Dr and staff.

#42018-08-31

overall professionalism of entire staff

#52018-07-26

There didn't seem to be an overload of other patients in the office, which is what I am normally used to from other offices.

#62011-01-04 15:49:01

How competent and smart and nice the Dr. is. I was struck by that immediately.

#72018-09-20

The professionalism of the staff and doctor. Everyone was easy to talk to and my questions were answered.

#82018-04-09

The treatments that are on display in the lobby. Also, the fact that the dermatologist told me the truth about commercial face cleansers.

#92018-06-24

Electronic Files

#102010-11-15 12:09:12

What can we do better?

(answers:373)

you can not top anything. this is the best run office and staff that I have ever been in.

#12011-05-26 11:49:32

It was good

#22018-06-03

Loved all the options for appointments, very appreciative. Thank you

#32011-02-23 17:51:48

Only the 30 minute wait time really should be shortened.

#42018-04-01

So glad I came. Always liked Dr. Kern and Ann Watson. He'd be so pleased with your entire professional setup

#52018-05-15

Improve the movement of the mouse on its pad.

#62018-08-11

Everything was great! No further suggestion at this time.

#72018-09-16

Everything was excellent.

#82018-07-20

Parking was a little tight.

#92011-06-09 15:52:46

I think the service provided fulfilled my expectations so at this time I do not have any suggestions for improvement.

#102018-03-31
Customer Rating : 4.8

Based on 4 ratings