BACKGROUND: Clinical and histopathologic features of childhood melanoma are poorly characterized. Atypical clinical presentations and ambiguous microscopic findings may contribute to diagnostic delays. OBJECTIVES: We sought to determine whether conventional ABCDE melanoma detection criteria (Asymmetry, Border irregularity, Color variegation, Diameter >6 mm, Evolution [any morphologic or symptomatic change in the lesion]) adequately detects pediatric melanoma and to evaluate clinicopathologic and outcome differences between younger and older children. METHODS: This was a retrospective study of children given the diagnosis of melanoma (N = 60) or ambiguous melanocytic tumors treated as melanoma (N = 10) before age 20 years from 1984 to 2009 at the University of California, San Francisco. Seventy patients were divided into 2 age groups: 0 to 10 years (N = 19, group A) and 11 to 19 years (N = 51, group B). Clinical, histopathologic, and outcomes data were collected. Main outcome measures were time from diagnosis to death and predictors of metastasis and death. RESULTS: In all, 60% of group A and 40% of group B children did not present with conventional ABCDE criteria. Rather, amelanosis, bleeding, "bumps," uniform color, variable diameter, and de novo development were most common. Histopathological subtypes differed significantly between groups (P = .002). In all, 44% were histopathologically unclassifiable using current melanoma subtypes. Stage IIA disease or higher comprised 92% and 46% of groups A and B, respectively (P = .05). Ten patients died: 1 in group A and 9 in group B. Of these, 70% had amelanotic lesions, and 60% had at least 1 major risk factor. Breslow thickness predicted metastasis (adjusted odds ratio 12.8 [CI 1.4-115]). LIMITATIONS: The retrospective design resulted in incomplete data capture. CONCLUSION: Additional ABCD detection criteria (Amelanotic; Bleeding, Bump; Color uniformity; De novo, any Diameter) used together with conventional ABCDE criteria may facilitate earlier recognition and treatment of melanoma in children.
BACKGROUND: Clinical and histopathologic features of childhood melanoma are poorly characterized. Atypical clinical presentations and ambiguous microscopic findings may contribute to diagnostic delays. OBJECTIVES: We sought to determine whether conventional ABCDE melanoma detection criteria (Asymmetry, Border irregularity, Color variegation, Diameter >6 mm, Evolution [any morphologic or symptomatic change in the lesion]) adequately detects pediatric melanoma and to evaluate clinicopathologic and outcome differences between younger and older children. METHODS: This was a retrospective study of children given the diagnosis of melanoma (N = 60) or ambiguous melanocytic tumors treated as melanoma (N = 10) before age 20 years from 1984 to 2009 at the University of California, San Francisco. Seventy patients were divided into 2 age groups: 0 to 10 years (N = 19, group A) and 11 to 19 years (N = 51, group B). Clinical, histopathologic, and outcomes data were collected. Main outcome measures were time from diagnosis to death and predictors of metastasis and death. RESULTS: In all, 60% of group A and 40% of group B children did not present with conventional ABCDE criteria. Rather, amelanosis, bleeding, "bumps," uniform color, variable diameter, and de novo development were most common. Histopathological subtypes differed significantly between groups (P = .002). In all, 44% were histopathologically unclassifiable using current melanoma subtypes. Stage IIA disease or higher comprised 92% and 46% of groups A and B, respectively (P = .05). Ten patients died: 1 in group A and 9 in group B. Of these, 70% had amelanotic lesions, and 60% had at least 1 major risk factor. Breslow thickness predicted metastasis (adjusted odds ratio 12.8 [CI 1.4-115]). LIMITATIONS: The retrospective design resulted in incomplete data capture. CONCLUSION: Additional ABCD detection criteria (Amelanotic; Bleeding, Bump; Color uniformity; De novo, any Diameter) used together with conventional ABCDE criteria may facilitate earlier recognition and treatment of melanoma in children.
Authors: Alon Scope; Michael A Marchetti; Ashfaq A Marghoob; Stephen W Dusza; Alan C Geller; Jaya M Satagopan; Martin A Weinstock; Marianne Berwick; Allan C Halpern Journal: J Am Acad Dermatol Date: 2016-06-17 Impact factor: 11.527
Authors: Bridget G Parsons; Jennifer L Hay; Lisa G Aspinwall; Kelsey Zaugg; Angela Zhu; Ryan H Mooney; Stephanie Z Klein; Douglas Grossman; Sancy A Leachman; Yelena P Wu Journal: J Cancer Educ Date: 2020-06 Impact factor: 2.037
Authors: Kelly G Paulson; Deepti Gupta; Teresa S Kim; Joshua R Veatch; David R Byrd; Shailender Bhatia; Katherine Wojcik; Aude G Chapuis; John A Thompson; Margaret M Madeleine; Jennifer M Gardner Journal: JAMA Dermatol Date: 2020-01-01 Impact factor: 10.282
Authors: Anne L Ryan; Charlotte Burns; Aditya K Gupta; Ruvishani Samarasekera; David S Ziegler; Maria L Kirby; Frank Alvaro; Peter Downie; Stephen J Laughton; Siobhan Cross; Timothy Hassall; Geoff B McCowage; Jordan R Hansford; Rishi S Kotecha; Nicholas G Gottardo Journal: Front Oncol Date: 2021-04-29 Impact factor: 6.244