Melanoma, past severe sunburns and multiple solar lentigines of the upper back and shoulders.

ABSTRACT

BACKGROUND: Multiple solar lentigines of the upper back and shoulders (MSLBS) have recently been demonstrated as being associated with intense sunburns in the past. OBJECTIVE: To determine the prevalence of MSLBS among patients with cutaneous melanoma. METHODS: Thisprevalence study was conducted prospectively from October 2003 to November 2004 in a single department of dermatology (Reims University Hospital, north of France). One hundred and twenty-five adult patients, followed up for a cutaneous melanoma, were included, and the prevalence of MSLBS was determined, with comparison of clinical characteristics of patients with and without these lesions. RESULTS: The prevalence of MSLBS among patients with cutaneous melanoma was 37.6%. MSLBS were significantly and independently associated with cutaneous melanoma of the back in multivariate analysis (adjusted odds ratio, OR = 4.3, 95% confidence interval, CI = 1.5-12.3) and with recalled episodes of severe sunburn before the age of 28 (OR = 3.4, 95% CI = 1.3-9.4). CONCLUSION: Large irregularly shaped brown macules of the upper back and shoulders or MSLBS are frequent among adult patients with cutaneous melanoma. They are associated with melanoma located on the upper back. This topographical association further illustrates the relation between past intense sunburns and cutaneous melanoma. MSLBS should be evaluated as an easily recognizable clinical marker of the risk of cutaneous melanoma.