Pediatric melanomas often mimic benign skin lesions: A retrospective study

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• 作者：Mario Mitkov ; MD^a ; ^{mitkov.mario@mayo.edu" class="auth_mail" title="E-mail the corresponding author} ; Marie Chrest ; BS^b ; Nancy N. Diehl ; BS^c ; Michael G. Heckman ; MS^c ; Megha Tollefson ; MD^d ; Anokhi Jambusaria-Pahlajani ; MD ; MSCE^a
• 关键词：Breslow depth ; childhood ; clinical appearance ; early detection ; melanoma ; pediatric
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：75
• 期：4
• 页码：706-711.e4
• 全文大小：165 K

文摘

Childhood melanoma can be misdiagnosed because of its rarity and atypical presentation.

Objective

We sought to correlate the clinical appearance of pediatric melanomas with Breslow depth and clinical behavior, and to identify diagnostic errors made by dermatologists and nondermatologist physicians.

Methods

This was a retrospective review of Mayo Clinic records of children and young adults 21 years of age or younger with a diagnosis of primary cutaneous melanoma between January 2000 and January 2015.

Results

Pediatric melanomas that mimicked benign skin lesions were more often deeper (>1 mm; odds ratio 5.48; P = .002) and had a higher T stage (odds ratio [T2, T3, or T4] 6.28; P = .001) than melanomas with a clinically malignant appearance. Of pediatric melanomas, 66% originally diagnosed as benign melanocytic lesions exhibited changes in size, shape, and color.

Limitations

Sample size and retrospective design are limitations.

Conclusions

Benign-appearing pediatric skin lesions with a history of evolution, bleeding, or ulceration should raise suspicion for melanoma. Melanomas demonstrating these features are associated with a higher Breslow depth and T stage. Although biopsy of all lesions that exhibit change in children is not practical, safe, or desired, close monitoring is recommended.