Many children with melanoma do not meet ABCDE criteria
Kelly M. Cordoro, M.D., from the University of California in San Francisco, and colleagues conducted a retrospective study involving 60 children with a diagnosis of melanoma and 10 children with ambiguous melanocytic tumors treated as melanoma, diagnosed before age 20 from 1984 to 2009. The patients were categorized by age: 0 to 10 years (19 patients, group A) and 11 to 19 years (51 patients, group B).
The researchers found that 60 and 40 percent of groups A and B, respectively, did not present with conventional ABCDE criteria. The most common features included amelanosis, bleeding, "bumps," uniform color, variable diameter, and de novo development. Significant between-group variation was observed in histopathological subtypes. Forty-four percent were considered histopathologically unclassifiable according to current melanoma subtypes. In groups A and B, 92 and 46 percent of patients, respectively, had stage IIA disease or higher (P = 0.05). One patient in group A and nine in group B died; 70 percent of these cases had amelanotic lesions and 60 percent had one or more major risk factors. Metastasis was predicted with Breslow thickness (adjusted odds ratio, 12.8).
"Additional ABCD detection criteria (Amelanotic; Bleeding, Bump; Color uniformity; De novo, any Diameter) used together with conventional ABCDE criteria may facilitate earlier recognition and treatment of melanoma in children," write the authors.
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