TY - JOUR
T1 - Pediatric melanomas often mimic benign skin lesions
T2 - A retrospective study
AU - Mitkov, Mario
AU - Chrest, Marie
AU - Diehl, Nancy N.
AU - Heckman, Michael G.
AU - Tollefson, Megha
AU - Jambusaria-Pahlajani, Anokhi
N1 - Publisher Copyright:
© 2016 American Academy of Dermatology, Inc.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Background Childhood melanoma can be misdiagnosed because of its rarity and atypical presentation. Objective We sought to correlate the clinical appearance of pediatric melanomas with Breslow depth and clinical behavior, and to identify diagnostic errors made by dermatologists and nondermatologist physicians. Methods This was a retrospective review of Mayo Clinic records of children and young adults 21 years of age or younger with a diagnosis of primary cutaneous melanoma between January 2000 and January 2015. Results Pediatric melanomas that mimicked benign skin lesions were more often deeper (>1 mm; odds ratio 5.48; P = .002) and had a higher T stage (odds ratio [T2, T3, or T4] 6.28; P = .001) than melanomas with a clinically malignant appearance. Of pediatric melanomas, 66% originally diagnosed as benign melanocytic lesions exhibited changes in size, shape, and color. Limitations Sample size and retrospective design are limitations. Conclusions Benign-appearing pediatric skin lesions with a history of evolution, bleeding, or ulceration should raise suspicion for melanoma. Melanomas demonstrating these features are associated with a higher Breslow depth and T stage. Although biopsy of all lesions that exhibit change in children is not practical, safe, or desired, close monitoring is recommended.
AB - Background Childhood melanoma can be misdiagnosed because of its rarity and atypical presentation. Objective We sought to correlate the clinical appearance of pediatric melanomas with Breslow depth and clinical behavior, and to identify diagnostic errors made by dermatologists and nondermatologist physicians. Methods This was a retrospective review of Mayo Clinic records of children and young adults 21 years of age or younger with a diagnosis of primary cutaneous melanoma between January 2000 and January 2015. Results Pediatric melanomas that mimicked benign skin lesions were more often deeper (>1 mm; odds ratio 5.48; P = .002) and had a higher T stage (odds ratio [T2, T3, or T4] 6.28; P = .001) than melanomas with a clinically malignant appearance. Of pediatric melanomas, 66% originally diagnosed as benign melanocytic lesions exhibited changes in size, shape, and color. Limitations Sample size and retrospective design are limitations. Conclusions Benign-appearing pediatric skin lesions with a history of evolution, bleeding, or ulceration should raise suspicion for melanoma. Melanomas demonstrating these features are associated with a higher Breslow depth and T stage. Although biopsy of all lesions that exhibit change in children is not practical, safe, or desired, close monitoring is recommended.
KW - Breslow depth
KW - childhood
KW - clinical appearance
KW - early detection
KW - melanoma
KW - pediatric
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U2 - 10.1016/j.jaad.2016.05.015
DO - 10.1016/j.jaad.2016.05.015
M3 - Article
C2 - 27430613
AN - SCOPUS:84995549327
SN - 0190-9622
VL - 75
SP - 706-711.e4
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 4
ER -