title: Clinical and histological features of head and neck melanoma: a population-based study in France.
abstract: BACKGROUND
  Head and neck melanomas (HNMs) account for an increasing proportion of melanomas and have a poor prognosis.
  
  
  OBJECTIVE
  To compare the clinical and histological characteristics of HNMs with those of melanomas at other sites (MOS), and to identify pertinent clinicopathological subgroups of HNM.
  
  
  METHODS
  A retrospective population-based study of incident in situ and invasive melanomas in the period 2004-2011 was performed.
  
  
  RESULTS
  HNMs represented 26·7% of 1548 melanomas, corresponding to a density ratio of 3·7 between HNMs and MOS. HNMs occurred later than MOS (71·2 vs. 58·4 years; P < 0·01), included a higher proportion of in situ cases (49·6% vs. 13·5%; P < 0·01) and were mainly lentigo malignant melanomas (73·0% vs. 2·6%; P < 0·01). Invasive HNMs included a higher proportion of thick (> 2 mm) tumours [33·7% vs. 24·1% (P = 0·01); mean Breslow thickness: 2·18 vs. 1·77 mm (P = 0·03)] and nodular melanomas (20·1% vs. 12%; P < 0·01). HNMs in the peripheral area of the head and neck differed from those of central location by a younger age of onset (65·2 vs. 72·4 years; P < 0·01), male predominance (64·4% vs. 33·8%; P < 0·01), and higher proportions of invasive (67·2% vs. 42%; P < 0·01) and nodular (15·1% vs. 7·5%; P = 0·01) melanomas.
  
  
  CONCLUSIONS
  HNMs highly differ from MOS, and are clinically and histologically heterogeneous, possibly as a consequence of different patterns of sun exposure. These data could help to improve primary and secondary prevention messages for patients and doctors.
authors.affiliation: Service de Dermatologie, Hôpital Robert Debré, CHU de Reims, Reims, France.
authors.forename: F
authors.initials: F
authors.lastname: Dabouz
authors.forename: C
authors.initials: C
authors.lastname: Barbe
authors.forename: C
authors.initials: C
authors.lastname: Lesage
authors.forename: A
authors.initials: A
authors.lastname: Le Clainche
authors.forename: G
authors.initials: G
authors.lastname: Arnoult
authors.forename: E
authors.initials: E
authors.lastname: Hibon
authors.forename: P
authors.initials: P
authors.lastname: Bernard
authors.forename: F
authors.initials: F
authors.lastname: Grange
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000453:epidemiology / Q000473:pathology*; D055815:Young Adult