Topografía y sub tipo de melanoma

Journal Scan / Research · February 09, 2020

The Anatomic Distribution of Cutaneous Melanoma

The Australasian Journal of Dermatology

TAKE-HOME MESSAGE

• The authors described the anatomic distribution of primary cutaneous melanoma cases with patient and tumor characteristics of individuals seen at a tertiary referral center, encompassing 5141 in situ or invasive melanomas (76.2% were invasive). The most common subtypes were 57.2% superficial spreading, 20.8% lentigo maligna, and 12.2% nodular. Similar to what is previously known, they found sun-exposed areas like the female nose and cheek, male ear, and upper back in both sexes had the highest incidence of melanoma. Compared with the posterior forearm, sites such as the scalp, ear, perioral, subungual, and preauricular areas had thicker invasive melanoma; nodular melanoma was most commonly seen in the ear, cheek, and periauricular areas.

• The authors suggest that these anatomic differences should be considered by physicians and patients in order to diagnose melanoma at earlier stages.

– Matthew Stein, MD

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.

The Australasian Journal of Dermatology

The Anatomic Distribution of Cutaneous Melanoma: A Detailed Study of 5141 Lesions

Australas. J. Dermatol. 2019 Dec 27;[EPub Ahead of Print], E Wee, R Wolfe, C Mclean, JW Kelly, Y Pan 

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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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