ositive family history.
Kefford (14) found evidence that germline mutations in either p16 or CDK4 (chromosome 12q) predispose carriers to a high lifetime risk of melanoma. The author suggests that since there is evidence for an enhanced susceptibility to sun exposure in some of these individuals, such predisposition may involve increased susceptibility to the mutagenic effect of UV irradiation in the skin.
For years, a wide and deep excision of primary cutaneous melanomas was recommended to achieve a better care and to decrease the risk of local recurrence of the disease. However, recent studies indicate that removal of peritumoral tissue beyond complete excision of the primary neoplasm does not decrease significantly the risk of local metastases, and in addition, confers no benefit to patient survival (18).
Harris, Shapiro and Roses (12) believe excision with conservative margins for thin lesions (less than 1.0mm in thickness) and more extensive margins for thicker lesions are appropriate. They report that most authors agree that lymph node
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