title: Sex-related location of head and neck melanoma strongly argues for a major role of sun exposure in cars and photoprotection by hair.
abstract: Head and neck melanomas (HNMs) are frequent and have a poorer prognosis than melanomas at other sites. Photoprotection in these locations is difficult. In this population-based study of 279 HNMs diagnosed in a French region between 2004 and 2009, major differences were found between genders. A clearcut, sex-related distribution was found between a "peripheral" area (scalp, forehead, temples, ears, and neck) and a "central" one (other parts of the face), with 56.7% of HNMs being located in the peripheral area in men and 79.3% in the central area in women (P<0.0001). Moreover, HNMs located in the peripheral area occurred on the left side in 57.6% of men and on the right side in 73.1% of women (P=0.009). Peripheral HNMs differed from central HNMs by a higher proportion of invasive tumors, nodular or superficial spreading melanomas, and a lower proportion of lentigo maligna melanomas (LMMs). We hypothesized that this differential distribution between men and women could be explained mostly by a major role of long-term photoprotection by hair and sun exposure in a car. Important public health messages could result from these observations, such as the role of hairstyles in melanoma prevention and the importance of reducing sun exposure in a car, particularly in professional drivers.
authors: Service de Dermatologie, Hôpital Robert Debré, Reims, France. clesage@chu-reims.fr
authors: Candice
authors: C
authors: Lesage
authors: Coralie
authors: C
authors: Barbe
authors: Annick
authors: A
authors: Le Clainche
authors: François-Xavier
authors: FX
authors: Lesage
authors: Philippe
authors: P
authors: Bernard
authors: Florent
authors: F
authors: Grange
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001336:Automobiles; D002610:Cheek / Q000473:pathology; D004423:Ear / Q000473:pathology; D005260:Female; D005546:Forehead / Q000473:pathology; D006197:Hair; D006257:Head / Q000473:pathology*; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000473:pathology*; D008875:Middle Aged; D009333:Neck / Q000473:pathology*; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology / Q000473:pathology; D009666:Nose / Q000473:pathology; D012042:Registries; D012189:Retrospective Studies; D012737:Sex Factors; D012878:Skin Neoplasms / Q000453:epidemiology / Q000473:pathology; D014466:Ultraviolet Rays / Q000009:adverse effects*