Melanoma
Melanoma in patients with skin of color differs with respect to incidence, anatomic location, and prognosis compared to Caucasians. While the overall incidence of melanoma in this population is lower, there is higher associated mortality, as patients pres
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Melanoma Sharif Currimbhoy and Divya Srivastava
45.1
Contents 45.1
Introduction......................................................................
273
45.2
Clinical Features ..............................................................
274
45.3
Diagnosis and Differential Diagnosis .............................
276
45.4
Histopathological Features..............................................
276
45.5
Natural History and Prognosis .......................................
276
45.6
Treatment .........................................................................
277
References ....................................................................................
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S. Currimbhoy, BS Department of Dermatology, University of Texas Southwestern Medical Center, 5939 Harry Hines Blvd, Dallas, TX 75235, USA e-mail: [email protected] D. Srivastava, MD (*) Department of Dermatology, University of Texas Southwestern Medical Center, 5939 Harry Hines Blvd., Suite 100, Dallas, TX 75390-9191, USA e-mail: [email protected]
Introduction
Melanoma affects approximately 77,000 Americans and 200,000 individuals worldwide every year and is the third most common skin cancer in patients with skin of color [1, 2]. Although patients of African American, Asian, Hispanic, and American Indian descent have a lower rate of melanoma than Caucasians, the variable presentation of lesions requires increased awareness on the part of the examining physician. The incidence of melanoma in Caucasian patients is estimated at 21.1 cases per 100,000 individuals, compared to 0.6–1.5 per 100,000 in African Americans. The rate of melanoma in Hispanics and Asians is slightly higher than in African Americans with 1.2–4.7 cases per 100,000 and 0.5–1.5 cases per 100,000, respectively [1–5]. The discrepancy in the incidence of melanoma in patients with skin of color can likely be attributed to higher melanin content in these individuals which provides a greater degree of photoprotection from carcinogenic ultraviolet radiation [3–7]. The incidence of melanoma increases with age in patients of all racial and ethnic groups, with the majority of melanomas presenting between ages 50 and 64 [4]. Patients of Hispanic, Asian, and American Indian descent are more likely to present at a younger age compared to African Americans and Caucasians [1]. With respect to gender, there is a higher rate of melanoma among females of African American, Asian, and Hispanic origin compared to Caucasians and American Indians in which a higher number of males are affected [2]. In contrast to Caucasians, risk factors such as ultraviolet radiation exposure and family history of melanoma are not thought to be significant factors for the development of melanoma in darker-skinned races [5]. Risk factors that have been implicated in the formation of melanoma in African Americans include albinism, burn scars, x-rays, history of trauma, and blistering sunburns [1, 4, 5].
D. Jackson-Richards, A.G. Pandya (eds.), Dermatology Atlas for Ski
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