• Melanoma in Children – Pediatric & Adolescent Cases

    by Dr. Rebecca Duff
    on Feb 19th, 2018

  There was a study published recently in the Journal of the American Academy of Dermatology that conducted a clinical study on 52 cases of melanoma in children. While it is true that the majority of melanoma cases occur in middle-age and senior patients, it is not a widely known fact that this cancer can occur in children as well. In fact, the number of melanomas is rising in both adults and children, which is something that often gets lost in the messages to the public about skin protection. We should mention, that although the cancer rates are rising in pediatric patients, it is still quite rare. Pediatric melanoma is a melanoma diagnosed during childhood, and it accounts for 1% to 4% of all melanoma cases. The National Cancer Institute estimates that approximately 500 children each year are diagnosed with melanoma. And a study that was published in 2013 found that melanoma cases in pediatric patients are rising at around 2% each year. The group of children with the greatest increase in cases is that of ages 15-19. This group is diagnosed roughly 10 times more than those ages 5-9. So, while it is rare, it is still something to watch rather closely.

 

  Pediatric melanomas tend to be thicker tumors at the time of detection. This is due, in part, to the delay in diagnosis as well as differences in growth dynamics. When you talk with a dermatologist about monitoring changes in the skin for melanomas, you often are told the ABCDs of suspicious moles (asymmetry, border irregularity, multiple colors, and a large diameter). This is a great standard for middle to senior aged patients, however the growing number of pediatric melanomas has led dermatologists to reconsider the signs to look for in children. In any sense, the increase in pediatric cases warrants a need to be vigilant in monitoring changes in a child’s skin. Again, melanoma in children is incredibly rare. On a national level, approximately 30% of all pediatric dermatology consults are in regards to a suspicious mole, and of those cases that truly warrant concern the mole-to-melanoma ratio, according to the most recent study published, is about 1:1000. So while we write this blog to educate parents on the importance of being aware of skin changes in their children, the reality is that the disease is extremely rare. Most pediatric dermatology visits are for the mild to moderately severe stuff like acne, warts, rashes, eczema, nail fungi, and atopic dermatitis.

 

For the purpose of purely education, let us look at the types of pediatric melanoma that can occur. There are three types:

  1. Conventional Melanoma: this type of melanoma is rarely diagnosed before puberty. Clinically, this pediatric melanoma shows several similarities to adult melanoma, hence the “conventional” name. There is evidence, published by the Journal of Investigative Dermatology, of similar UV-induced DNA damage and similar UV-induced mutations to that seen in adult melanomas.
  2. Spitzoid Melanoma: this type of pediatric melanoma is tricky. Spitzoid Melanomas are often nodular in nature, round in shape, and uniform in color. So in short, Spitzoid Melanomas do not typically follow the commonly used ABCD guide to spotting/diagnosing melanoma. These melanomas often lack common genetic mutations seen in adult melanoma. There is no clear cause for these melanomas currently.
  3. Congenital Melanocytic Nevus: this type of melanoma is a large, pigmented mole or birthmark that is present at birth. What is most interesting is that current research suggests that approximately 5-10% of these Congenital Melanocytic Nevus cases develop into melanoma later in life. Similar to Spitzoid melanomas, there is no clear cause for these tumors.

 

  Knowledge on skin cancer developing in children is sparse, and with the recent study that was published we thought it worth talking about. We value information and we enjoy utilizing the blog to educate the patients we serve. As a whole, skin cancer is the most common cancer diagnosed each year in the United States, and in the Hattiesburg-Laurel, Mississippi areas we see a lot of skin cancers. At Pine Belt Dermatology skin cancers are our bread and butter, so we like to help our patients be as vigilant as possible when it comes to detecting suspicious lesions on the skin. Schedule an appointment with us today if you, or a loved one, need a skin screening.

Author Dr. Rebecca Duff Pine Belt Dermatology Physician

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