[Etiologic factors of malignant melanoma in young adults]. / Fiatalkori melanomák etiológiai tényezoi.

ABSTRACT

BACKGROUND: Malignant melanoma is the most aggressive type of skin cancers, involving the cutis and the mucosa. Its incidence keeps increasing dramatically in the last decades. It appears rarely in childhood. The main environmental risk factors are excessive sun exposure and severe sunburns in both childhood and adolescence. Skin phototype, number of nevi, presence of congenital nevi (especially giant congenital nevi) and non-melanoma skin cancer in previous history refer to increased risk. Investigations of genetical factors have come to the front. The role of hormonal influences and traumas are recurring questions. AIM: The presence of melanoma typically concerns the middle-aged population. The purpose of this study was to determine the main risk factors, etiology factors and predisposing pediatric conditions in development of melanoma in young adulthood (under the age of 30). METHOD: A total of 70 new, histologically verified melanoma patient under 30 years were examined between 1993-2003 with a retrospective study. Results of questionnaire based survey and clinical data base about melanoma risk factors were also analysed. RESULTS: 5% of patients had giant congenital nevi, although in half of the patients (19/40) more than 20 moles were found. On the basis of patients' histories 57.5% of melanomas developed on a nevus existing from birth or childhood. 30% of melanomas developed on a pigmented brown alteration which rose on the normal skin. About 1/3 of patients had fair skin type and almost all patients (38/40) suffered from erythematous sunburn at first sunbath. Melanoma developed mostly on the trunk and lower extremities. 51.5% of patients belonged to Stage I (Breslow thickness below 1 mm in 33%). CONCLUSION: There were 70 young (under 30 years) patients were treated for malignant melanoma at the Dermatology Department of the National Institute of Oncology in Budapest from 1993 till 2003. The incidence of melanoma under the age of 30 was 3.3%. In young adulthood the main risk factors were the number of atypical nevi and repeated or severe sunburns in childhood. The skin type was also an important risk factor. 50% of the melanomas in young women developed on the trunk. Authors could not prove any relationship among hormonal factors, pregnancy and the development of the melanoma.