Melanoma: A silver lining in the black cloud of COVID-19

Dermatology Publications on COVID-19 during the First Pandemic Year: Creativity or Opportunism?

Introduction: Dermatologists had to face several challenges during the COVID-19 pandemic. In this scenario, a large amount of data has been produced and published. Objectives: We present a literature analysis of publications on COVID-19 in the dermatology field in the first year of the pandemic. Methods: The research was carried out by searching the PubMed database using keywords related to “COVID-19” combined with the keyword “Dermatology” in the “affiliation” search field and collecting articles published from February 2020 to December 2020. Results: A total of 816 publications from 57 countries were retrieved. Overall, publications increased notably along the timespan considered in this study and appeared to be closely linked to pandemic progression in different countries. In addition, article types (i.e., commentaries, case reports, original research) appeared to be strictly influenced by the pandemic’s progression. However, the number and category of these publications may raise questions regarding the scientific relevance of the messages reported. Conclusions: Our analysis provides a descriptive quantitative analysis and suggests that publications do not always respond to real scientific needs but are sometimes linked to a need/opportunity for publication.

The Effect of the COVID-19 Lockdown on Melanoma Diagnosis in Italy

The coronavirus disease 2019 (COVID-19) pandemic has led to lockdowns for much of the world. In Italy, all health procedures not directly related to COVID-19 were reduced or suspended, thus limiting patient access to hospitals. Any delay in cancer treatment presents the additional risk of tumors progressing from being curable to incurable. Specifically, melanoma survival rate strictly depends on tumor thickness, which, in turn, is a function of time. To estimate the impact on melanoma progression caused by the reduction in dermatologic services during the COVID-19 lockdown, a retrospective observational cohort study was conducted. This study was designed to compare the clinical and histologic characteristics of the primary melanomas removed in the first 2 months after the end of the lockdown (May-July 2020) in 12 Italian centers characterized by different COVID-19 case frequencies. The control group was represented by the melanomas removed during the same period in the previous 3 years. Overall, 1,124 melanomas were considered: 237 as part of the study group and 887 from the control group (average, 295), with a 20% reduction. Breslow thickness, as well as high-risk histotypes and melanomas with vertical growth, increased for all melanomas. Ulcerated and high mitotic index melanomas increased, particularly in northern Italy. In Italy, the lockdown led to a significant worsening of melanoma severity, causing a staging jump, with a consequent worsening of outcomes.