Childhood melanoma: an increasingly important health problem in the USA.
OBJECTIVE
To inform pediatricians of the challenges of detection of melanoma in children and adolescents as well as to instruct on proper biopsy technique of suspicious lesions.


RESULTS
The incidence of melanoma in children and adolescents is on the rise with an average increase of 2% per year. Rates of change are higher in adolescent girls and locations with low UV-B exposure. Standard Amelanotic, Bleeding, Bump, Color uniformity, De novo, any Diameter (ABCD) detection criteria fail to detect most childhood melanomas. Tumor thickness and sentinel lymph node status are the most important prognostic factors. Artificial tanning use is prevalent among adolescent girls and likely contributes to the growing incidence of melanoma in this group.


CONCLUSIONS
Childhood melanoma is often amelanotic and may also appear as raised or ulcerated lesions commonly mistaken for warts or other benign skin conditions. Excision and full-thickness punch biopsies are indicated for suspicious lesions, whereas shaves and small punch biopsies are to be avoided. Pediatric patients more frequently have positive sentinel lymph nodes and increased tumor thickness, yet similar survival compared with adults.
aDepartment of Pediatric Surgery, The University of Texas Medical School at Houston bDepartment of Pediatrics, Children's Cancer Hospital, The University of Texas M.D. Anderson Cancer Center cDepartment of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA.
Austen D
AD
Slade
Mary T
MT
Austin
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004307:Dose-Response Relationship, Radiation; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008198:Lymph Nodes; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000517:prevention & control; D009367:Neoplasm Staging; D009381:Neoplasms, Radiation-Induced / Q000473:pathology* / Q000517:prevention & control; D011322:Primary Prevention / Q000379:methods*; D011481:Protective Clothing / Q000706:statistics & numerical data; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy; D012867:Skin / Q000473:pathology*; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000517:prevention & control; D013473:Sunscreening Agents / Q000008:administration & dosage; D013997:Time Factors; D014466:Ultraviolet Rays / Q000009:adverse effects; D014481:United States
D013473:Sunscreening Agents