title: Excised melanocytic lesions in children and adolescents - a 10-year survey.
abstract: BACKGROUND
  Early recognition and prompt excision is to date the only available strategy for reducing mortality from melanoma. Little is known about the accuracy of melanoma detection in children and adolescents.
  
  
  OBJECTIVE
  To assess the accuracy of melanoma detection in a paediatric population.
  
  
  METHODS
  From the Department of Dermatology, Medical University of Graz, Austria, we reviewed the dermatopathology reports of naevi and melanomas excised in patients younger than 20 years over a 10-year period (1998-2007). Patients were subdivided into four age groups: 0-4, 5-9, 10-14 and 15-19 years.
  
  
  RESULTS
  Accuracy in melanoma detection was tested using the number needed to excise (NNE) value that is obtained by dividing the total number of excised lesions by the number of melanomas. A total of 22564 lesions were reviewed, disclosing 22526 naevi and 38 melanomas, for an overall NNE value of 593.8. Five melanomas were excised in children aged 10-14 years (NNE 1141) and 33 in children aged 15-19 years (NNE 479.8), whereas no melanomas were found among 1026 lesions excised in children younger than 10 years. In children aged 0-4 years, congenital and Spitz/Reed naevi accounted for 34.5% and 20% of lesions, respectively. These percentages decreased progressively when moving to older age groups (P<0.0001). In contrast, the percentage of dermal and compound naevi rose in direct proportion with age, being 3.4% and 20.7%, respectively, in the youngest age group, and 36.7% and 31.9%, respectively, among the oldest patients (P<0.0001).
  
  
  CONCLUSIONS
  The overall NNE value in paediatric patients over the 10-year study period was 593.8, meaning that about 594 lesions were excised to find one melanoma. This value is 20 times higher than the rates found in adult patients.
authors.affiliation: Department of Oncological Dermatology, Santa Maria and San Gallicano Dermatologic Institute, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Moscarella
authors.forename: I
authors.initials: I
authors.lastname: Zalaudek
authors.forename: L
authors.initials: L
authors.lastname: Cerroni
authors.forename: I
authors.initials: I
authors.lastname: Sperduti
authors.forename: C
authors.initials: C
authors.lastname: Catricalà
authors.forename: J
authors.initials: J
authors.lastname: Smolle
authors.forename: R
authors.initials: R
authors.lastname: Hofmann-Wellenhof
authors.forename: A
authors.initials: A
authors.lastname: Sgambato
authors.forename: G
authors.initials: G
authors.lastname: Pellacani
authors.forename: G
authors.initials: G
authors.lastname: Argenziano
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D055088:Early Detection of Cancer / Q000592:standards*; D006801:Humans; D007223:Infant; D008545:Melanoma / Q000175:diagnosis* / Q000601:surgery; D009508:Nevus, Pigmented / Q000175:diagnosis* / Q000601:surgery; D061366:Numbers Needed To Treat; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000601:surgery; D055815:Young Adult