BACKGROUND: A series of studies have investigated epidemiological, clinical and genetic characteristics of multiple primary melanoma (MPM) patients. However, a comparison of the clinical and dermoscopic features of MPM within a given individual have been described only in case reports. OBJECTIVE: To describe the dermoscopic features of MPM for each given patient, and to evaluate the characteristics eventually associated with the similar or dissimilar appearance. METHODS: From the databases of three skin lesion clinics in US, Italy, and Spain we collected the dermoscopic images of melanomas in patients diagnosed with MPM. RESULTS: Among 58 patients with MPM, we found 53.5% of patients having dermoscopically similar melanomas and 46.5% of patients having dermoscopically different melanomas. In older patients 59.1% of melanomas were dermoscopically similar vs 46.9% in younger patients (p=0.377). Similar thickness was associated with the occurrence of dermoscopically similar melanomas (19 cases; 63.3%) (p=0.039). Most (65.4%) of the synchronous lesions were similar, compared to 35.7% of non-synchronous lesions (p=0.029), and most (69%) of the melanomas on sun-damaged skin were similar, vs 36.7% of melanomas on non sun-damaged skin (p=0.015; OR=3.88; CI 95%, 1.11-13.98). The percentage of dermoscopically different melanomas was higher in patients with a family history of melanoma (66.7% vs 47.7%). LIMITATIONS: Thin and superficial spreading melanomas were predominant in our study population, this may have restricted variation in dermoscopic features according to tumour type. Information about positive family history for melanoma and mutation in CDKN2A gene were only partially documented in our series. CONCLUSION: MPM in a given patient have almost the same chance to look dermoscopically similar or different. However, a subset of elderly patients with sun-damaged skin may present multiple, similar, thin melanomas characterized by pigment network and regression structures.
Multiple primary melanomas: do they look the same ? / E., Moscarella; H., Rabinovitz; S., Puig; I., Zalaudek; Oliviero, M. C.; L., Brown; I., Alarcon; J., Malvehy; Longo, Caterina; D., Formisano; C., Carrera; C., Badenas; S., Piana; G., Albertini; Pellacani, Giovanni; G., Argenziano. - In: BRITISH JOURNAL OF DERMATOLOGY. - ISSN 0007-0963. - STAMPA. - 168:(2013), pp. 1267-1272. [10.1111/bjd.12260]
Multiple primary melanomas: do they look the same ?
LONGO, Caterina;PELLACANI, Giovanni;
2013
Abstract
BACKGROUND: A series of studies have investigated epidemiological, clinical and genetic characteristics of multiple primary melanoma (MPM) patients. However, a comparison of the clinical and dermoscopic features of MPM within a given individual have been described only in case reports. OBJECTIVE: To describe the dermoscopic features of MPM for each given patient, and to evaluate the characteristics eventually associated with the similar or dissimilar appearance. METHODS: From the databases of three skin lesion clinics in US, Italy, and Spain we collected the dermoscopic images of melanomas in patients diagnosed with MPM. RESULTS: Among 58 patients with MPM, we found 53.5% of patients having dermoscopically similar melanomas and 46.5% of patients having dermoscopically different melanomas. In older patients 59.1% of melanomas were dermoscopically similar vs 46.9% in younger patients (p=0.377). Similar thickness was associated with the occurrence of dermoscopically similar melanomas (19 cases; 63.3%) (p=0.039). Most (65.4%) of the synchronous lesions were similar, compared to 35.7% of non-synchronous lesions (p=0.029), and most (69%) of the melanomas on sun-damaged skin were similar, vs 36.7% of melanomas on non sun-damaged skin (p=0.015; OR=3.88; CI 95%, 1.11-13.98). The percentage of dermoscopically different melanomas was higher in patients with a family history of melanoma (66.7% vs 47.7%). LIMITATIONS: Thin and superficial spreading melanomas were predominant in our study population, this may have restricted variation in dermoscopic features according to tumour type. Information about positive family history for melanoma and mutation in CDKN2A gene were only partially documented in our series. CONCLUSION: MPM in a given patient have almost the same chance to look dermoscopically similar or different. However, a subset of elderly patients with sun-damaged skin may present multiple, similar, thin melanomas characterized by pigment network and regression structures.
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