Site‐dependent actinic skin damage as risk factor for melanoma in a central European population

Abstract

Subscribe to PCMR and stay up-to-date with the only journal committed to publishing basic research in melanoma and pigment cell biology As a member of the IFPCS or the SMR you automatically get online access to PCMR. Sign up as a member today at www.ifpcs.org or at www.societymelanomaresarch.org SummarySun exposure is causal for melanoma but is subject to bias of recall so that it is difficult to dissect the role of particular patterns of sun exposure. In this hospital-based case-control study (n = 1991), we aimed to analyze pigmentation traits and signs of actinic damage at different anatomic locations as markers of melanoma risk in central European patients. Although all signs of actinic damage (freckling, wrinkling and solar lentigos)were significantly associated with melanoma risk in multivariate logistic regression models adjusting for age and sex, the strongest associations were observed for the dorsal parts of the body: adjusted odds ratios [OR] were 4.22 for wrinkling on the neck, 3.43 for solar lentigos and 3.37 for freckling on the back (all P < 0.001), respectively. These associations were independent of age, sex and pigmentation traits. Our results indicate that signs of actinic damage are predictors of melanoma risk, particularly on the back.

Characterization of patients at high risk of melanoma in Austria

“…All 1668 histologically confirmed patients with melanoma who were recruited from 2008 to 2015 as part of the M3 case–control study were included . The participants originated mainly from Vienna, the province of Lower Austria, and Burgenland (Table S1; see Supporting Information).…”

“…To address a potential selection bias, patients were included from different Austrian hospitals. The data were collected by blood draw and a questionnaire, as described elsewhere . Those with an unavailable pathology report or occult melanoma were not included in this study.…”

Actinic damage on the back is significantly determined by MC1R variants and previous sun exposure compared with other body sites in a multivariate analysis

“…Participants who were not of Austrian origin were descendants from other central European countries such as Belgium, Czech Republic, Germany, Hungary, the Netherlands, Poland, Romania, Slovakia and Switzerland. Overall, 2112 participants were included in the analyses; 52·7% ( n = 1113) were diagnosed with melanoma and 47·3% ( n = 999) were diagnosed with other dermatological diseases . The mean age at recruitment of all participants was 59 years (± 15·55 SD; Table ).…”

“…Variables included in our analyses were skin phototype, hair colour, number of sunburns and sun‐exposure variables such as outdoor occupation, recreational time and holidays (Table ). The following alterations were considered to be ‘actinic damage’: wrinkling, defined as deep skin lines on the forehead, periorbital, perioral and on the neck; freckling, defined as areas of hyperpigmentation, resulting in a mottled, irregular skin appearance; and solar lentigines, defined as brown, macular lesions with sharp margins . These different signs of actinic skin damage were then graded according to their severity into three categories as described elsewhere: 0, absent; +, mild; ++/+++, moderate to severe.…”

“…MC1R is the major determinant of pigmentation, and genetic variants of this gene are associated with the production of the less protective pheomelanin leading to red hair, fair skin and poor ability to tan . However, signs of actinic damage are not limited to the face only, and previously, we have demonstrated that actinic damage on the back is a more reliable indicator of melanoma risk than analogous signs on the face . As most studies were limited to just one type of actinic damage at one anatomical location, mostly the face, the findings were not adjusted for potentially confounding factors .…”