Adjuvant therapies for melanoma are largely predicated on staging so it’s crucial that the stage optimally stratifies risk. Ulceration, a known harbinger of more aggressive disease, upstages, but what about lesions that are in the process of ulceration (i.e., severe thinning or loss of epidermis with stratum corneum still intact). An Australian case control study retrospectively identified 40 cases of impending or “incipient” ulceration against which 80 matched nonulcerated controls exhibited better recurrence-free (HR 0.37) and overall (HR 0.49) survival. | Paver, JAMA Dermatol 2023
