Edmund Wee1,2, Rory Wolfe2, Catriona Mclean1, John W Kelly1, Yan Pan1. 1. Victorian Melanoma Service, Alfred Health, Melbourne, Victoria, Australia. 2. Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
Abstract
BACKGROUND/ OBJECTIVES: There is evidence that cutaneous melanomas at different anatomic sites present with distinctive clinicopathologic features. We examined the anatomic distribution of cutaneous melanoma and its variation by patient characteristics, subtype and Breslow thickness, using high-resolution anatomic site data. METHODS: A cross-sectional study was performed of all primary cutaneous melanoma cases managed at a tertiary referral centre, analysing prospectively collected clinical data across 50 anatomic subsites. RESULTS: The study included 5141 in situ or invasive melanomas; most were invasive (76.2%), and the median Breslow thickness of invasive lesions was 1.0 mm. Superficial spreading (57.2%), lentigo maligna (20.8%) and nodular (12.2%) were the most common histopathological subtypes. Sun-exposed sites such as the female nose and cheek, the male ear, as well as the upper back in both sexes had the highest incidence of melanoma per unit area. When compared to the posterior forearm, the scalp, ear, preauricular, perioral, subungual and plantar sites had thicker invasive melanomas (each P < 0.05). The peri-auricular, ear and cheek had the highest incidence of nodular melanoma per unit area. There were subtype-, age- and sex-specific differences in melanoma anatomic distribution. CONCLUSION: Melanoma most commonly arises in sun-exposed facial areas, as well as the upper back. Increased thickness is found for melanoma in acral and many head and neck sites. Nodular melanoma is more likely to occur in head and neck sites including the peri-auricular area, ear and cheek. Clinicians should carefully assess these sites during skin examinations.
BACKGROUND/ OBJECTIVES: There is evidence that cutaneous melanomas at different anatomic sites present with distinctive clinicopathologic features. We examined the anatomic distribution of cutaneous melanoma and its variation by patient characteristics, subtype and Breslow thickness, using high-resolution anatomic site data. METHODS: A cross-sectional study was performed of all primary cutaneous melanoma cases managed at a tertiary referral centre, analysing prospectively collected clinical data across 50 anatomic subsites. RESULTS: The study included 5141 in situ or invasive melanomas; most were invasive (76.2%), and the median Breslow thickness of invasive lesions was 1.0 mm. Superficial spreading (57.2%), lentigo maligna (20.8%) and nodular (12.2%) were the most common histopathological subtypes. Sun-exposed sites such as the female nose and cheek, the male ear, as well as the upper back in both sexes had the highest incidence of melanoma per unit area. When compared to the posterior forearm, the scalp, ear, preauricular, perioral, subungual and plantar sites had thicker invasive melanomas (each P < 0.05). The peri-auricular, ear and cheek had the highest incidence of nodular melanoma per unit area. There were subtype-, age- and sex-specific differences in melanoma anatomic distribution. CONCLUSION:Melanoma most commonly arises in sun-exposed facial areas, as well as the upper back. Increased thickness is found for melanoma in acral and many head and neck sites. Nodular melanoma is more likely to occur in head and neck sites including the peri-auricular area, ear and cheek. Clinicians should carefully assess these sites during skin examinations.
Authors: Kirsten M Baecher; Michael K Turgeon; Caroline R Medin; Geetha Mahendran; Terrill M Flakes; Keith A Delman; Michael C Lowe Journal: Am Surg Date: 2021-11-11 Impact factor: 0.688
Authors: Jeremy Hay; Jeff Keir; Clara Jimenez Balcells; Nikita Rosendahl; Martelle Coetzer-Botha; Tobias Wilson; Simon Clark; Astrid Baade; Cath Becker; Luke Bookallil; Chris Clifopoulos; Tony Dicker; Martin Paul Denby; Douglas Duthie; Charles Elliott; Paul Fishburn; Mark Foley; Mark Franck; Irene Giam; Patricio Gordillo; Alister Lilleyman; Roger Macauley; James Maher; Ewen McPhee; Michael Reid; Bob Shirlaw; Graeme Siggs; Robert Spark; John Stretch; Keith van Den Heever; Thinus van Rensburg; Chris Watson; Harald Kittler; Cliff Rosendahl Journal: Australas J Dermatol Date: 2022-04-19 Impact factor: 2.481