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Is Pediatric Melanoma Really That Different from Adult Melanoma? A Multicenter Epidemiological, Clinical and
Vincenzo De Giorgi1,2, Elisabetta Magnaterra1, Biancamaria Zuccaro1
1Section of Dermatology, Department of Health Sciences, University of Florence, 50121 Florence, Italy.
Insights
This study found that classic ABCDE criteria are more sensitive than modified pediatric criteria for diagnosing melanoma in children. Most pediatric melanomas were pigmented, and at least two dermoscopic criteria were present in all cases, aiding early diagnosis.
Area of Science:
- Dermatology
- Pediatric Oncology
- Dermoscopy
Background:
- Pediatric melanoma is rare but requires accurate diagnosis and management.
- Existing diagnostic criteria may not be optimal for children.
- Understanding clinical and dermoscopic features is crucial for early detection.
Purpose of the Study:
- To enhance diagnostic accuracy for pediatric melanomas.
- To optimize the management of melanoma in patients under 18.
- To compare diagnostic algorithm performance in pediatric cases.
Main Methods:
- Retrospective, multicenter study of 39 pediatric melanoma cases.
- Collected data on sociodemographics, clinical, and dermoscopic features.
- Evaluated classic ABCDE criteria versus a modified pediatric ABCDE algorithm.
Main Results:
- The modified pediatric ABCDE algorithm showed lower sensitivity than conventional criteria.
- Irregular streaks/pseudopods were the most common dermoscopic finding (74.4%).
- Most lesions (64.1%) exhibited two suspicious dermoscopic criteria.
Conclusions:
- Contrary to literature, most pediatric melanomas in this series were pigmented (95%).
- The presence of at least two dermoscopic criteria is a key indicator for suspected pediatric melanoma.
- These findings support early dermoscopic diagnosis in children.
Purpose:
To improve the diagnostic accuracy and optimal management of pediatric melanomas.
Methods:
We conducted a retrospective descriptive, multicenter study of the epidemiological, clinical, and dermoscopic characteristics of histopathologically proven melanomas diagnosed in patients less than 18 years old. Data on sociodemographic variables, clinical and dermoscopic characteristics, histopathology, local extension, therapy and follow-up, lymph node staging, and outcome were collected from the databases of three Italian dermatology units. We performed a clinical evaluation of the morphological characteristics of each assessed melanoma, using both classic ABCDE criteria and the modified ABCDE algorithm for pediatric melanoma to evaluate which of the two algorithms best suited our series.
Results:
The study population consisted of 39 patients with a histologically confirmed diagnosis of pediatric melanoma. Comparing classic ABCDE criteria with the modified ABCDE algorithm for pediatric melanomas, the modified pediatric ABCDE algorithm was less sensitive than the conventional criteria. Dermoscopically, the most frequent finding was the presence of irregular streaks/pseudopods (74.4%). When evaluating the total number of different suspicious dermoscopy criteria per lesion, 64.1% of the lesion assessments recognized two dermoscopic characteristics, 20.5% identified three, and 15.4% documented four or more assessments.
Conclusions:
Contrary to what has always been described in the literature, from a clinical point of view, about 95% of our cases presented in a pigmented and non-amelanotic form, and these data must be underlined in the various prevention campaigns where pediatric melanoma is currently associated with a more frequently amelanotic form. All the pediatric melanomas analyzed presented at least two dermoscopic criteria of melanoma, suggesting that this could be a key for the dermoscopic diagnosis of suspected pediatric melanoma, making it possible to reach an early diagnosis even in this age group.
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