Increased melanoma risk in Parkinson disease: a prospective clinicopathological study.
OBJECTIVE
To evaluate the possible association of Parkinson disease (PD) and melanoma in North America.


METHODS
Thirty-one centers enrolled patients with idiopathic PD. At visit 1, a neurologist obtained a medical history. At visit 2, a dermatologist recorded melanoma risk factors, performed a whole-body examination, and performed a biopsy of lesions suggestive of melanoma for evaluation by a central dermatopathology laboratory. We compared overall prevalence of melanoma with prevalence calculated from the US Surveillance Epidemiology and End Results (SEER) cancer database and the American Academy of Dermatology skin cancer screening programs.


RESULTS
A total of 2106 patients (mean [SD] age, 68.6 [10.6] years; duration of PD, 7.1 [5.7] years) completed the study. Most (84.8%) had received levodopa. Dermatology examinations revealed 346 pigmented lesions; dermatopathological findings confirmed 20 in situ melanomas (0.9%) and 4 invasive melanomas (0.2%). In addition, histories revealed 68 prior melanomas (3.2%). Prevalence (5-year limited duration) of invasive malignant melanoma in the US cohort of patients with PD (n = 1692) was 2.24-fold higher (95% confidence interval, 1.21-4.17) than expected in age- and sex-matched populations in the US SEER database. Age- or sex-adjusted relative risk of any melanoma for US patients was more than 7 times that expected from confirmed cases in American Academy of Dermatology skin cancer screening programs.


CONCLUSIONS
Melanoma prevalence appears to be higher in patients with PD than in the general population. Despite difficulties in comparing other databases with this study population, the study supports increased melanoma screening in patients with PD.
Bertoni
John M
JM
Department of Neurological Sciences, University of Nebraska Medical Center, 982045 Nebraska Medical Center, Omaha, NE 68198-2045, USA.
Arlette
John Philip
JP
Fernandez
Hubert H
HH
Fitzer-Attas
Cheryl
C
Frei
Karen
K
Hassan
Mohamed N
MN
Isaacson
Stuart H
SH
Lew
Mark F
MF
Molho
Eric
E
Ondo
William G
WG
Phillips
Tania J
TJ
Singer
Carlos
C
Sutton
James P
JP
Wolf
John E
JE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D008875:Middle Aged; D009656:North America; D010300:Parkinson Disease / Q000453:epidemiology* / Q000473:pathology; D015995:Prevalence; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D018426:SEER Program; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology