Characteristics of Melanoma in White and Nonwhite Children, Adolescents, and Young Adults | PracticeUpdate

Characteristics of Melanoma in White and Nonwhite Children, Adolescents, and Young Adults

Journal Scan / Research · May 14, 2019

Pediatric Dermatology

Abstract

OBJECTIVES

To characterize clinical differences among nonwhite/multiethnic vs white children, adolescents, and young adults with melanoma or atypical melanocytic neoplasms, including atypical Spitz tumors.

PATIENTS AND METHODS

A cohort of 55 patients (< 25 years of age) prospectively followed from 1995 to 2018 in the Stanford Pigmented Lesion and Melanoma Program was analyzed for differences in clinical presentation, including skin phototype, race/ethnicity, age, sex, tumor/melanoma characteristics, and outcome.

RESULTS

Seventeen patients (9 males and 8 females) were classified as nonwhite (predominantly skin phototype IV) and of Hispanic, Asian, or Black/African American ethnicity, and 38 patients (21 males and 17 females) were classified as white (predominantly phototypes I/II). Ages ranged from 6 months to 24 years, and median follow-up was 36 months (range 1-180 months). Melanomas were diagnosed in 87% of whites in our cohort, compared to 65% of nonwhites, with the remainder representing mainly atypical Spitz tumors. Lesions were usually brought to the attention of a health care provider by the patient or family (P < 0.05). Compared with whites, nonwhites were more likely to present at a younger mean age (10.9 years vs 15.4 years, P < 0.05) and with pink/clinically amelanotic tumors (59% vs 24%, P = 0.02).

CONCLUSIONS

This long-term prospective institutional study showed clinically relevant differences between nonwhite vs white children, adolescents, and young adults diagnosed with melanoma and atypical melanocytic neoplasms. Nonwhite patients presented at a younger age and had more clinically amelanotic melanocytic tumors. Increased recognition of clinical factors and risk of these tumors in nonwhites could result in earlier diagnosis.

TAKE-HOME MESSAGE

• This prospective study evaluated 17 nonwhite patients and 38 white patients (<25 years of age) with melanoma or atypical melanocytic neoplasms. The age at presentation was younger and pink/clinically amelanotic tumors were fewer in nonwhite patients (10.9 vs 15.4 years). Additionally, spitzoid and nodular lesions were the most common melanoma subtypes among nonwhite patients (45% and 36%, respectively).

• Children with nonwhite skin color are more likely to present with amelanotic melanocytic tumors at a younger age. Considering the growing incidence of pediatric melanoma, an increased awareness of the unique features of melanoma in young nonwhite patients among the general population and physicians is required.

– InYoung Kim, MD, PhD

Pediatric Dermatology

Characteristics of Melanoma in White and Nonwhite Children, Adolescents, and Young Adults: Analysis of a Pediatric Melanoma Institutional Registry, 1995-2018

Pediatr Dermatol 2019 Apr 16;[EPub Ahead of Print], OK Afanasiev, JH Tu, DH Chu, SM Swetter 

http://www.practiceupdate.com/content/characteristics-of-melanoma-in-white-and-nonwhite-children-adolescents-and-young-adults/83323

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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