Ocular melanoma and cutaneous melanoma

Abstract

Dear Sir,We welcome the data of Hemminki et al. 1 from the Swedish Family-Cancer Database that show an association between cutaneous and ocular melanoma although only when cutaneous melanoma (CM) follows an ocular melanoma (CM) (SIR 4.01, 95% CI 2.24 -6.62) and not the reverse (SIR 0.87, 95% CI 0.16 -2.57). These associations are consistent with those reported by Shors et al. 2 in U.S. Surveillance, Epidemiology and End Results (SEER) data. The lack of an increased risk of OM after CM, however, in these 2 studies is based on only 10 OMs, and a summary SIR calculated from these 2 studies, 1.2 with 95% CI 0.6 -2.6, is compatible with the significant increase in risk of OM in people who gave a prior history of CM (summary OR over all OM categories 2.1 (1.2-3.5) in our Australian case-control study. 3 Our study, as Hemminki et al. 1 state, also produced strong evidence that sun exposure was positively associated with choroid and ciliary body melanoma, the most common site of ocular melanoma, and was most persuasive for occupational sun exposure and in the first 20 years of life, especially in men. 3

The Co-occurrence of Ocular and Cutaneous Melanomas—Reply

“…This asymmetric relationship was subsequently reproduced in another population-based registry, the Swedish Family-Cancer Database, 4 and hypotheses for the relationship put forth. 2,4,5 If an etiology such as sun exposure is considered, it may be that persons with ocular melanoma have acquired sufficient sun exposure to also cause cutaneous melanoma. Persons may develop cutaneous melanoma following sun exposure in different amounts or in a qualitatively different manner (eg, trunk radiation as opposed to head and neck radiation) than is sufficient to result in ocular melanoma.…”

“…biopsied "For Cause"), finasteride only reduced the positive biopsy rate in those patients by 10% (29.5% placebo vs 26.5% finasteride). 4 The "end of study" biopsies of the men who did not undergo biopsy during the 7 years (no PSA Ͼ4.0 ng/mL, no induration on DRE) showed a 60% increase in high-(REPRINTED) ARCH DERMATOL / VOL 140, JULY 2004…”