Risk factors for the development of a second melanoma in patients with cutaneous melanoma

Abstract

Background Cutaneous melanoma patients have an increased risk of developing other neoplasms, especially cutaneous neoplasms and other melanomas. Identifying factors associated with an increased risk might be useful in the development of melanoma guidelines. Objectives To identify risk factors related to the development of a second primary melanoma in a series of patients diagnosed with sporadic melanoma and to establish the estimated incidence rate. Methods A longitudinal study based on prospective follow-up information of patients diagnosed with sporadic cutaneous melanoma at our centre from 2000 to 2015 was performed. Cumulative incidence was estimated based on competing risk models, and the association of characteristics with the risk of a second melanoma was performed by Cox proportional hazard models. Results Out of 1447 patients included in the study, after a median follow-up of 61 months, 55 patients (3.8%) developed a second melanoma. Fair hair colour, more than 100 common melanocytic nevi and the presence of more than 50 cherry angiomas were independently associated with the development of a second melanoma. The site and the histological subtype of the first and second melanomas were not consistent. The second melanomas were thinner than the first ones. Conclusions Fair-haired and multiple-nevi patients might benefit from more intensive prevention measures. The finding of cherry angiomas as a risk factor suggests that these lesions could be markers of skin sun damage in the setting of certain degree of genetic susceptibility.

Eruptive Cherry Angiomas and Skin Melanoma: Further Insights into an Intriguing Association

“…The association between numerous CAs and skin MM was comparable to that between MM and multiple atypical melanocytic naevi, regarding the strength of association, and was found to be stronger than that between MM and numerous melanocytic naevi. This finding further supports a probable link between the development of numerous CAs and occurrence of skin MM [1,2,5]. Eruptive CAs seem to be associated with tumours, in general, other than MM, whereas they do not seem to be linked to benign melanocytic naevi, in terms of both number and clinical atypia.…”

“…We cannot exclude that applying different cutoffs, especially for the total count of melanocytic naevi, or considering other variables, such as the number of moles on both arms [27,28], could lead to different results. The same consideration can be extended to the cut-off of the main study variable, that is, "eruptive CAs", which elsewhere was > 50 [5]. A study aimed to assess a linear association between the overall number of CAs and MM could help deepen and possibly corroborate our findings.…”

“…Interestingly, the results from subsequent studies, although very heterogeneous by methodology, design and objectives, seemed to support a likely association between CAs and tumours, namely breast cancer [3] and MM [4]. A recent study found that the presence of more than 50 CAs was significantly associated with an increased risk of developing a second MM in patients with cutaneous melanoma [5]. On the other hand, we stressed that our findings merely showed the presence of an association while a cause-effect relation was not established.…”

Anatomic Distribution of Cherry Angiomas in the General Population

“…“Eruptive” angiomas is a condition referring to having multiple cherry angiomas. However, the term is not well defined, with a prevalence in adults varying from 5 to 74% depending on age and what is considered “multiple,” with cut-offs ranging from >10 to >50 of these lesions [2, 8, 9]. Factors associated with having >30 cherry angiomas include increasing age, male sex, immunosuppressive treatment, and cutaneous and extracutaneous malignancies [2].…”

Identification and Construction of a Predictive Immune-Related lncRNA Signature Model for Melanoma

“…Risk factors for melanoma can be divided into internal and external factors and include light skin color, UV exposure, nevi, genetic predisposition, and a family history of melanoma. [3][4][5][6] In 2019, there were an estimated 95,830 cases of skin melanoma and 7000 deaths from skin melanoma in the United States. 7 Depending on the features of the tumor (location, stage, and genetic profile), the therapeutic options may include surgical resection, chemotherapy, radiotherapy, photodynamic therapy (PDT), immunotherapy, or targeted therapy.…”