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Characteristics of melanoma in white and nonwhite children, adolescents, and young adults: Analysis of a pediatric melanoma institutional registry, 1995‐2018
Author(s) -
Afanasiev Olga K.,
Tu Joanna H.,
Chu Derek H.,
Swetter Susan M.
Publication year - 2019
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.13836
Subject(s) - medicine , phototype , melanoma , cohort , prospective cohort study , young adult , dermatology , pediatrics , cancer research
Objectives To characterize clinical differences among nonwhite/multiethnic vs white children, adolescents, and young adults with melanoma or atypical melanocytic neoplasms, including atypical Spitz tumors. Patients and Methods A cohort of 55 patients (< 25 years of age) prospectively followed from 1995 to 2018 in the Stanford Pigmented Lesion and Melanoma Program was analyzed for differences in clinical presentation, including skin phototype, race/ethnicity, age, sex, tumor/melanoma characteristics, and outcome. Results Seventeen patients (9 males and 8 females) were classified as nonwhite (predominantly skin phototype IV ) and of Hispanic, Asian, or Black/African American ethnicity, and 38 patients (21 males and 17 females) were classified as white (predominantly phototypes I/ II ). Ages ranged from 6 months to 24 years, and median follow‐up was 36 months (range 1‐180 months). Melanomas were diagnosed in 87% of whites in our cohort, compared to 65% of nonwhites, with the remainder representing mainly atypical Spitz tumors. Lesions were usually brought to the attention of a health care provider by the patient or family ( P < 0.05). Compared with whites, nonwhites were more likely to present at a younger mean age (10.9 years vs 15.4 years, P < 0.05) and with pink/clinically amelanotic tumors (59% vs 24%, P = 0.02). Conclusions This long‐term prospective institutional study showed clinically relevant differences between nonwhite vs white children, adolescents, and young adults diagnosed with melanoma and atypical melanocytic neoplasms. Nonwhite patients presented at a younger age and had more clinically amelanotic melanocytic tumors. Increased recognition of clinical factors and risk of these tumors in nonwhites could result in earlier diagnosis.