An increasing incidence of cutaneous malignant melanoma had been observed in the Netherlands. Therefore, between 1989 and 1992 a preventive skin cancer campaign was organized in part of western Netherlands. The effect of this screening campaign has yet to be evaluated by investigating the distribution of all in situ and invasive primary cutaneous melanoma according to anatomical subsite, tumour thickness, and histological type in a population-based study during 1980-92. A total number of 2236 (1361 female; 875 male) invasive and 580 (395 female; 185 male) in situ melanomas were diagnosed. The median age of patients with thin lesions was 46 years, intermediate lesions 54 years, and thick lesions 65 years, which may be indicative of slow tumour progression. The median thickness of the invasive lesions was 0.9 mm for women and 1.1 mm for men and the invasive to in situ ratio was 3.4 for female and 4.7 for male subjects, suggesting a reasonable awareness of melanoma in this population. The relative tumour density (RTD) was remarkably high for melanomas in the head/neck area for both sexes and invasive melanoma on the male trunk and the lower legs of females. The low RTD of invasive melanomas on the lower limbs of men and the high density in the head/neck area for both sexes are remarkable and support the aetiological role of ultraviolet exposure. It is concluded that our findings are in many ways similar to those of other descriptive studies.
An increasing incidence of cutaneous malignant melanoma had been observed in the Netherlands. Therefore, between 1989 and 1992 a preventive skin cancer campaign was organized in part of western Netherlands. The effect of this screening campaign has yet to be evaluated by investigating the distribution of all in situ and invasive primary cutaneous melanoma according to anatomical subsite, tumour thickness, and histological type in a population-based study during 1980-92. A total number of 2236 (1361 female; 875 male) invasive and 580 (395 female; 185 male) in situ melanomas were diagnosed. The median age of patients with thin lesions was 46 years, intermediate lesions 54 years, and thick lesions 65 years, which may be indicative of slow tumour progression. The median thickness of the invasive lesions was 0.9 mm for women and 1.1 mm for men and the invasive to in situ ratio was 3.4 for female and 4.7 for male subjects, suggesting a reasonable awareness of melanoma in this population. The relative tumour density (RTD) was remarkably high for melanomas in the head/neck area for both sexes and invasive melanoma on the male trunk and the lower legs of females. The low RTD of invasive melanomas on the lower limbs of men and the high density in the head/neck area for both sexes are remarkable and support the aetiological role of ultraviolet exposure. It is concluded that our findings are in many ways similar to those of other descriptive studies.
Naevus spilus (NS) is characterized by congenital or acquired darkly pigmented macules and papules with background hyperpigmentation. It usually presents as a single lesion, but can be multiple, and may be distributed in a zosteriform pattern along a dermatome (1). NS has also been described in association with an epidermal naevus and scoliosis (1). The prevalence of NS in the general population is estimated to be 0.2-2.3%. Frequent locations are the trunk and lower limbs (2-5). NS occur in all skin types (3). Somatic activating HRAS mutations were identified recently as the potential underlying cause of small single NS, which separates them from the congenital melanocytic naevi that show NRAS or BRAF mutations (6, 7). Malignant transformation of a NS is rare. In 1957, Perkinson described for the first time a melanoma appearing in NS in a patient with neurofibromatosis (8). Since then, several cases have been reported of in situ melanoma developing in NS (2, 4, 5, 9-30). This article focusses on patients with segmental NS. They can show a flag-like, block-like or chequerboard café-au-lait pattern with superimposed naevi increasing in number during childhood and adolescence (31). The prevalence of segmental NS or the incidence of melanomas occurring within the NS has not been well studied. METHODS Patients with segmental NS >20 cm were collected from the database (January 2004 to December 2015) of the department of dermatology, Leiden University Medical Centre, the Netherlands. Clinical records were reviewed for initial presentation, changes during follow-up and results of biopsies or excisions. Photographic documentation was observed. Patients with NS-type congenital naevi, which were described recently as a specific subtype of congenital naevi were excluded (32). A review of the literature (Pub-Med search 1936-September 2015, Search (((((("nevus spilous") OR "naevus spilous") OR "naevus spilus") OR "nevus spilus") OR "zosteriform lentiginous nevus") OR "speckled lentiginous nevus") was performed.
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