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Evaluation of the Merits and Limitations of Evidence-Based Medicine

Evaluation of the Merits and Limitations of Evidence-Based Medicine Letters epidermal alterations and dermal vasculitic changes seen in colleagues described a retrospective study of patients with bi- this patient are important findings to inform our understand- opsy-proven severe DN. In that study, melanoma was found ing of the pathophysiologic mechanism of skin lesions in pa- in 2 of 165 reexcision specimens (1.2%), 1 of which contained tients with COVID-19. invasive melanoma, as well as in 3% of so-called severe DN ac- cording to a repeated pathologic review. Rather than support- Laurence Toutous Trellu, MD ing the conclusion of Pournamdari et al that dermatologists Gürkan Kaya, MD, PhD should reconsider reexcision for histologic findings of DN, it Chloé Alberto, MD seems clear that more research is necessary, particularly in the Adrien Calame form of prospective trials. Thomas McKee, MD, PhD On the basis of a single study by Stiegel et al examining Alexandra Calmy, MD, PhD SLN positivity and melanoma outcomes, and despite letters to the editor after its publication detailing its limitations, Pour- Author Affiliations: Department of Dermatology and Venereology, Geneva namdari and colleagues state, “The SLN status does not pro- University Hospitals, Geneva, Switzerland (Trellu, Kaya, Alberto); Department of vide additional prognostic information beyond BT [Breslow Clinical http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Dermatology American Medical Association

Evaluation of the Merits and Limitations of Evidence-Based Medicine

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Publisher
American Medical Association
Copyright
Copyright 2020 American Medical Association. All Rights Reserved.
ISSN
2168-6068
eISSN
2168-6084
DOI
10.1001/jamadermatol.2020.1940
Publisher site
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Abstract

Letters epidermal alterations and dermal vasculitic changes seen in colleagues described a retrospective study of patients with bi- this patient are important findings to inform our understand- opsy-proven severe DN. In that study, melanoma was found ing of the pathophysiologic mechanism of skin lesions in pa- in 2 of 165 reexcision specimens (1.2%), 1 of which contained tients with COVID-19. invasive melanoma, as well as in 3% of so-called severe DN ac- cording to a repeated pathologic review. Rather than support- Laurence Toutous Trellu, MD ing the conclusion of Pournamdari et al that dermatologists Gürkan Kaya, MD, PhD should reconsider reexcision for histologic findings of DN, it Chloé Alberto, MD seems clear that more research is necessary, particularly in the Adrien Calame form of prospective trials. Thomas McKee, MD, PhD On the basis of a single study by Stiegel et al examining Alexandra Calmy, MD, PhD SLN positivity and melanoma outcomes, and despite letters to the editor after its publication detailing its limitations, Pour- Author Affiliations: Department of Dermatology and Venereology, Geneva namdari and colleagues state, “The SLN status does not pro- University Hospitals, Geneva, Switzerland (Trellu, Kaya, Alberto); Department of vide additional prognostic information beyond BT [Breslow Clinical

Journal

JAMA Dermatology – American Medical Association

Published: Aug 24, 2020

References

  • A state-of-the-art review highlighting medical overuse in dermatology, 2017-2018: a systematic review
    Pournamdari, AB; Tkachenko, E; Barbieri, J; Adamson, AS; Mostaghimi, A
  • Prognostic value of sentinel lymph node biopsy according to Breslow thickness for cutaneous melanoma
    Stiegel, E; Xiong, D; Ya, J
  • Comment on “Prognostic value of sentinel lymph node biopsy according to Breslow thickness for cutaneous melanoma”
    Lo, SN; Stodell, MD; Scolyer, RA; Thompson, JF
  • Cutaneous melanoma, version 2.2019, NCCN Clinical Practice Guidelines in Oncology
    Coit, DG; Thompson, JA; Albertini, MR
  • Melanoma staging: evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual.
    Gershenwald, JE; Scolyer, RA; Hess, KR