Background
Melanoma is a rare diagnosis in the pediatric population. Differences in incidence, presentation, and survival distinguish pediatric melanoma from adult melanoma. In order to improve our understanding of pediatric melanoma, our case series investigates differences in incidence, age of onset, and anatomic site between male and female pediatric melanoma patients in Colorado between 1988 and 2015.
Methods
All data were gathered from the Colorado Central Cancer Registry. A request for de‐identified data on pediatric melanoma patients between 1988 and 2015 was made by the University of Colorado Department of Dermatology. Chi‐square tests were used to compare the differences reported in melanoma between sex, age‐groups, and site of lesion.
Results
A total of 256 cases of melanoma were reported in Colorado in patients < 20 years of age between 1988 and 2015. Overall incidence of pediatric melanoma in Colorado increased from 1988 to 1999 but declined from 2001 to 2011. There was a significant predominance of female cases in the 10‐14 age‐group (P = 0.0477) and 15‐19 age‐group (P = 0.0472). Both groups had increased incidence of melanoma with increasing age. The mean age of onset for both sexes was 16 years old. Boys were more likely to have melanoma of the scalp and neck (P = 0.0523) and less likely to have melanoma of the leg (P = 0.0049).
Conclusion
Among the pediatric population, girls 10‐14 and 15‐19 years old are at a significantly increased risk of melanoma compared to boys in these age‐groups. Our study found sex‐specific differences in anatomic site consistent with prior literature. Further investigations should aim to identify causes for these sex‐specific differences in order to better guide public health initiatives.
Background: While the Psoriasis Area and Severity Index (PASI) represents the most commonly used assessment tool for psoriasis severity, it has been criticized for its complexity in clinical practice. Objective: To validate a simplified 2-item patient-administered limited measure psoriasis area and severity score (PALMPASS) compared to standardized measure of psoriasis. Materials and Methods: This was a prospective observational survey of adult patients with psoriasis and psoriatic arthritis in Veterans Affairs Medical Center (VAMC) dermatology and rheumatology clinics participating in the Program to Understand the Longterm outcomes in SpondyloARthritis registry between January and June 2016 (n = 885). Patients at 7 US VAMCs (n = 363) completed a 2-item, 11-point PALMPASS questionnaire, assessing (1) how psoriasis affected the patient and (2) the degree of surface area involvement. Results from the PALMPASS were then compared to the PASI, the Psoriasis Symptom Inventory (PSI) and the Dermatology Life Quality Index (DLQI). Data were analyzed using Lin concordance, intraclass correlations, Spearman correlations, and linear regression. Results: Strong correlations existed between PALMPASS and PASI (Spearman ρ = 0.74, P < .001), PSI (Spearman ρ = 0.71, P = .001), and DLQI (Spearman ρ = 0.77, P < .001). Results were comparable in analyses based on intraclass correlations. Elevated C-reactive protein concentrations correlated with higher PALMPASS. Conclusion: The PALMPASS is a patient-reported instrument that demonstrates validity and serves as a reliable and simplified tool to guide evidence-based management.
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