Is Pediatric Melanoma Really That Different from Adult Melanoma? A Multicenter Epidemiological, Clinical and Dermoscopic Study

Abstract

Purpose: To improve the diagnostic accuracy and optimal management of pediatric melanomas. Methods: We conducted a retrospective descriptive, multicenter study of the epidemiological, clinical, and dermoscopic characteristics of histopathologically proven melanomas diagnosed in patients less than 18 years old. Data on sociodemographic variables, clinical and dermoscopic characteristics, histopathology, local extension, therapy and follow-up, lymph node staging, and outcome were collected from the databases of three Italian dermatology units. We performed a clinical evaluation of the morphological characteristics of each assessed melanoma, using both classic ABCDE criteria and the modified ABCDE algorithm for pediatric melanoma to evaluate which of the two algorithms best suited our series. Results: The study population consisted of 39 patients with a histologically confirmed diagnosis of pediatric melanoma. Comparing classic ABCDE criteria with the modified ABCDE algorithm for pediatric melanomas, the modified pediatric ABCDE algorithm was less sensitive than the conventional criteria. Dermoscopically, the most frequent finding was the presence of irregular streaks/pseudopods (74.4%). When evaluating the total number of different suspicious dermoscopy criteria per lesion, 64.1% of the lesion assessments recognized two dermoscopic characteristics, 20.5% identified three, and 15.4% documented four or more assessments. Conclusions: Contrary to what has always been described in the literature, from a clinical point of view, about 95% of our cases presented in a pigmented and non-amelanotic form, and these data must be underlined in the various prevention campaigns where pediatric melanoma is currently associated with a more frequently amelanotic form. All the pediatric melanomas analyzed presented at least two dermoscopic criteria of melanoma, suggesting that this could be a key for the dermoscopic diagnosis of suspected pediatric melanoma, making it possible to reach an early diagnosis even in this age group.

Clinical, Dermoscopic, and Histological Characteristics of Melanoma Patients According to the Age Groups: A Retrospective Observational Study

“…Furthermore, the youngest group of adult patients (18–30 years) showed a dermoscopic similarity of melanomas with the patients described by Carrera et al regarding the pediatric population—a spitzoid (pigmented or non-pigmented) and non-spitzoid (predominant multicomponent asymmetric) pattern [ 38 ]. Recently, De Giorgi et al indicated a new finding—that pediatric melanomas were predominantly pigmented (95% of their cases) and characterized by at least two melanoma-specific structures in dermoscopy, among which the streaks and pseudopods (typical for the spitzoid pattern) were the most commonly found [ 39 ]. This could be explained by recent data, which indicated that genetic, rather than UV-induced, factors are responsible for the evolution of spitzoid lesions (Spitz/Reed nevi, spitzoid melanoma, and atypical spitzoid tumours) [ 25 ].…”

Melanoma and menarche: Exploring the hormonal impact in pediatric cases

“…We performed a comprehensive analysis of pediatric melanoma cases as well. 2 One particularly noteworthy observation was a significant disparity in mean Breslow thickness between two distinct age cohorts: children aged 0-12 years and adolescents aged 13-18 years. Specifically, the younger age group exhibited a mean thickness of 2.02 mm, whereas the older age group demonstrated a markedly lesser thickness, 0.77 mm.…”