Sex-Related Location of Head and Neck Melanoma Strongly Argues for a Major Role of Sun Exposure in Cars and Photoprotection by Hair

Abstract

Head and neck melanomas (HNMs) are frequent and have a poorer prognosis than melanomas at other sites. Photoprotection in these locations is difficult. In this population-based study of 279 HNMs diagnosed in a French region between 2004 and 2009, major differences were found between genders. A clearcut, sex-related distribution was found between a "peripheral" area (scalp, forehead, temples, ears, and neck) and a "central" one (other parts of the face), with 56.7% of HNMs being located in the peripheral area in men and 79.3% in the central area in women (P<0.0001). Moreover, HNMs located in the peripheral area occurred on the left side in 57.6% of men and on the right side in 73.1% of women (P=0.009). Peripheral HNMs differed from central HNMs by a higher proportion of invasive tumors, nodular or superficial spreading melanomas, and a lower proportion of lentigo maligna melanomas (LMMs). We hypothesized that this differential distribution between men and women could be explained mostly by a major role of long-term photoprotection by hair and sun exposure in a car. Important public health messages could result from these observations, such as the role of hairstyles in melanoma prevention and the importance of reducing sun exposure in a car, particularly in professional drivers.

Malignant melanoma in Chile: different site distribution between private and state patients

“…Besides of the differences in genital MM, females from both strata show a higher number of MM in the legs than males; these results are in agreement with those obtained by others authors and are probably due to many different sexual dimorphic cultural or genetic factors [13, 15]. Moreover, males from both strata showed a higher number of MM in ears than females probably due to sun protection by hair, in agreement with results of other authors [22]. The fact that females from HSS showed more MM in dorsal feet and in dorsal hands than females from LSS is not clear for us; it may be due to different factors, as for example skin type and sun exposure.…”

Gender aspects of recreational sun‐protective behavior: results of a representative, population‐based survey among Austrian residents

“…Socioculturally determined gender identity and associated clothing, hair styles, and hairiness exert a dominating influence on the individual's skin health protective behavior. In this verve, gender‐specific anatomic locations of melanoma reflect these different patterns of sun protection habits .…”

Lentigo Maligna and Lentigo Maligna Melanoma: Contemporary Issues in Diagnosis and Management

“…Risk factors for the development of LM include history of sun exposure, light skin and propensity toward development of lentigines. LM is most commonly found on the cheek (estimated at 26-48% of lesions) [7][8][9]. Unlike superficial spreading melanoma, LMM is more strongly associated with previous development of lentigines and skin cancer history, and is not associated with pre-existing nevi or propensity toward development of nevi [10,11].…”