title: Assessment of regression in successive primary melanomas.
abstract: OBJECTIVE
  It has been suggested that patients who have had a melanoma may develop increased immunity against certain antigens expressed by tumor-associated melanocytes. Thus our objective was to review the records of patients with successive primary melanomas to ascertain whether the pattern of regression might indicate the presence of an immunization effect arising from the first melanoma.
  
  
  METHODS
  A review of all the cases recorded in the melanoma database of our dermatology department between 2000 and 2012 identified 19 patients who had multiple asynchronous melanomas (2.56% of all the cases recorded). We studied the presence or absence of regression in these melanomas and other clinical and histological characteristics.
  
  
  RESULTS
  The presence of regression was significantly higher in successive melanomas than in the first tumors identified (42.10% vs 21.05%, P=.018). Regression of at least 1 melanoma was observed in 42.10% of the patients studied and regression of 2 melanomas was observed in 21.05%. In no case was regression observed in the first melanoma and not in the second; however, in 21.05% of the patients there was evidence of regression in the second tumor and none in the first.
  
  
  CONCLUSIONS
  Our findings suggest the possibility that the first melanoma produces an immunization effect in some patients who develop multiple asynchronous melanomas.
authors.affiliation: Servicio de Dermatología, Hospital Clínico Universitario, Valencia, España. Electronic address: Martin.josemaria@gmail.com.
authors.forename: J M
authors.initials: JM
authors.lastname: Martín
authors.affiliation: Servicio de Dermatología, Hospital Clínico Universitario, Valencia, España.
authors.forename: I
authors.initials: I
authors.lastname: Pinazo
authors.affiliation: Servicio de Dermatología, Hospital Clínico Universitario, Valencia, España.
authors.forename: J F
authors.initials: JF
authors.lastname: Mateo
authors.affiliation: Servicio de Dermatología, Hospital Clínico Universitario, Valencia, España.
authors.forename: I
authors.initials: I
authors.lastname: Escandell
authors.affiliation: Servicio de Dermatología, Hospital Clínico Universitario, Valencia, España.
authors.forename: E
authors.initials: E
authors.lastname: Jordá
authors.affiliation: Servicio de Anatomía Patológica, Hospital Clínico Universitario, Valencia, España.
authors.forename: C
authors.initials: C
authors.lastname: Monteagudo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000276:immunology* / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009365:Neoplasm Regression, Spontaneous / Q000276:immunology*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000276:immunology* / Q000473:pathology / Q000601:surgery*
keywords: Immunity; Inmunidad; Melanoma; Regresión; Regression