The patterns of melanoma presentation

Abstract

There is a global rising incidence of melanoma. For different reasons patterns of incidence, appearance, gender, anatomical distribution and outcome vary in different geographic area. Screening programs leaded to better early detection of melanoma in Australia and some world areas. National Cancer registry and practice data show incidence in Croatia is constantly rising. Despite public education programs about early discovery, in clinics we still see many new advanced stage melanoma.We analyzed data from 157 patients, cured and followed for 10 years for T1b-T4aN0 skin melanoma. There was a difference in anatomical distribution of melanoma lesions in correlation with patients age (ANOVA test, F=3.51, p=0,009). A higher prevalence of shoulder melanoma in young people was found, and head/neck in old (post-hoc Sheffe test, p=0.038).The T4 lesions were more found in men, and T1 mainly in women (Pearson c2 test, c2 =12.08, p=0.016). There was no difference in Clark level, but significantly higher Breslow stage was found in men (t=-2.52, p=0.013). Men were much prone to have head and neck, body, and shoulder melanoma; women had more melanoma on their legs and arms. Clark and Breslow level were strongly correlated in leg melanoma; head localization had no correlation at all. As conclusion, more attention should be devoted to improve results in melanoma detection in men, especially with the prevalence of body (back), head/neck localization, sometimes not prone to visual detection. Pattern of distribution show also the need for more attention to shoulder melanoma in younger people.</p