COMMENTARY |
Department of Surgery
Johns Hopkins Medical Institutions
Baltimore, MD 21287
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Melanoma is thought to occur rarely in children. However, a number of recent publications and our own experience clearly indicate that a profound change in the natural history of melanoma is now occurring and that melanoma, indeed, is occurring much more frequently in children and teenagers. In this issue of Pediatrics, Ferrari et al report the experience of the Instituto Nazionale Tumori (Milan, Italy) with childhood melanoma over a 25-year time span.1 The clinical presentation, treatment, and outcome for children
14 years old are described in this retrospective study. The authors report that among 33 patients, half had what could be considered an atypical presentation, with amelanotic or other unusual lesion, and that children <10 years old as a group had better outcomes than children from 10 to 14 years old.
There is increasing evidence that the incidence of melanoma is rising in children.2,3 In our own practice at the Johns Hopkins Melanoma Center, we have observed a noticeable increase in melanoma cases among the pediatric population over the past few years, particularly in adolescents. The importance of considering the diagnosis in children is
Address correspondence to Julie R. Lange, MD, ScM, Department of Surgery, Johns Hopkins University, 600 N Wolfe St, Carnegie 681, Baltimore, MD 21212. E-mail: jlange@jhmi.edu
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