Dr. Ana Margarita Duarte, director of Miami Children’s Hospital’s division of dermatology since 1995, began to get interested in that specialty when she was studying at the University of Miami medical school and completed residencies in pediatrics and dermatology.

“Dermatology is my calling, the profession I love until this day,” says Duarte, of Cuban parents, who is the president of Children’s Skin Center, where she has her private practice.

Skin cancer is not as common in children, but it happens and you must be prepared to detect it.

“Some children are born with pigmented spots that can be small, medium or large, on any part of the body,” she says. “And they run the risk of developing melanomas in those spots. Basal cell carcinoma can affect children, but squamous cell carcinoma is extremely rare in them.”

Pediatricians generally refer such cases to Miami Children’s Hospital for evaluation when the spots begins to change. There the children are examined, a biopsy is performed, and, depending on the results, the child is operated on or referred to a plastic surgeon who performs a graft with the child’s own skin to cover the wound.

Melanoma is the deadliest of skin cancers. It is essential for a person with spots or moles to learn to detect any change in their form or color, and determine whether they bleed or itch. Any change should be reported to a dermatologist pediatrician.

“Melanoma has now reached epidemic proportions. It is fundamental to treat it early to maximize its healing potential,’’ Duarte says.

As preventative, sunscreen must be applied generously 30 minutes before going out, and it must have no less than a 45 SPF in addition to ingredients to block UVB and UVA radiation. It is best to apply sunscreen every two or three hours. And preventive measures such as umbrellas, sunglasses and hats should be used.

“It’s also helpful to reduce the peril of sunburn because it doubles the risk of contracting skin cancer besides speeding up premature aging and producing a lot of dryness in the skin. If the person is not careful during their childhood, they might have to visit the dermatologist at age 30 or 40 with skin cancer,” Duarte says.

Several times a year dermatologists offer free tests to detect skin cancer, both at Miami Children’s Hospital and other places, especially in May, the month dedicated to melanoma. Even patients without health insurance are eligible for these tests. Miami Children’s Hospital’s department of social services works on each case, particularly to offer services to uninsured children.

Duarte does not only treat children.

“One of the beautiful things of this field is the flexibility of what is possible,” she says. “Sometimes we can treat not only the baby but also the mother and the grandmother. My patients are the most important part of my practice and it gives me great satisfaction to see them improve, as was the case of Neyton Sequeira.”

Niatieska Rodríguez discovered a cancerous spot on her son Neyton in the same place where she has a benign one: the right foot’s little toe. It drew her attention and she touched it. The boy, then 2 1/2, said it hurt. She took him to the pediatrician, who said it was hereditary and advised her to wait six months to see if it grew. But Niatieska opted not to wait and took him to Miami Children’s Hospital.

“When I met Dr. Duarte, I told her that I had a gut feeling that what my son had was malignant. Dr. Duarte performed a biopsy and repeated it two weeks later. Two months later Neyton had surgery,” the mother recalls.

She knew they could amputate his toe if the melanoma was very deep. Fortunately, that was not necessary because the cancer had been detected early and, with plastic surgery, a graft was performed with skin taken from his groin.

“All that I remember of my surgery is a bright light over me and doctors with scalpels around me,” says Neyton, now 12. “I had pain in my foot.”

The boy goes to the hospital every six months to be tested and to have new spots removed. Since his first operation, four spots have been removed, all benign: two on his foot, one on his back and another one on his neck. Neyton takes care of his toes, avoids exposure to the sun and educates his classmates about melanomas. “It was a big lesson not only for him but for the entire family,” his mother says.