Pediatric Melanoma

Eileen Bailey Health Guide
  • We think of melanoma as an adult disease; one that occurs after years of damage from the sun. And while it is true that most cases of skin cancer occur in adults, it does sometimes develop in children. According to a study released in 2013, the incidence rate of pediatric skin cancer has increased by 2 percent every year between 1973 and 2009. In the early 1970s, there were less than 250 cases of pediatric melanoma diagnosed each year. Today, that number has jumped to over 500 per year.

     

    According to the study, boys were more likely to get skin cancer on their faces and trunks and girls were more likely to have skin cancer on their lower legs and hips. The highest increase in the rate of skin cancer was found in girls between the ages of 15 and 19. While the reasons for the increase in skin cancer were not definitive, researchers noted the same risk factors as adults: fair skin, light colored hair and eyes, moles and a family history of melanoma. Sun exposure was still considered a risk, however, in very young children, sun exposure could not have played a large role.

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    Difficulties in Diagnosis


    Skin cancer has traditionally been considered an adult disease. Doctors and dermatologists may miss a diagnosis, or misdiagnose a skin lesion because of this. But another problem is the skin cancer in children doesn’t always follow the ABCDE rule. One study, published in February 2013 found that 60 percent of children younger than 10 years old did not meet the ABCDE criteria. Forty percent of those between the ages of 11 and 19 also did not meet the criteria. This creates a higher chance of misdiagnosis or delayed diagnosis.

     

    Signs of Pediatric Melanoma


    It’s important to know the signs of skin cancer in adults as in many cases, these are the same signs of skin cancer in children:

    A – Moles that are asymmetrical- if you draw a line down the middle the two sides do not match

    B – Border – moles with edges that are uneven

    C – Color – moles that have different shades of color or changes color

    D – Diameter – the size is usually larger than the eraser on a pencil

    E – Evolving – the mole changes in size, shape, color or elevation or begins to bleed, itch or crust

     

    If moles in children have these characteristics, a dermatologist should be consulted.

     

    But it is also important to know that, especially in young children, skin cancer lesions do not always fit the criteria.  Other signs to look for include:

    • A bump that itches and bleeds
    • Wart-like bumps that do not have pigment or are pinkish in color
    • Lesions that do not have pigment
    • Moles that look different than other moles your child has or are larger in size

    In the early stages, skin cancer lesions in children can look like a bug bite or a wart. If your child has a lesion that does not respond to treatment, does not go away or begins to bleed and itch, you should talk to your doctor and see a dermatologist.

     

    References:

     

    “Do You Know Your ANCDEs?” Date Unknown, Staff Writer, Skin Cancer Foundation

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    “Incidence of Childhood and Adolescent Melanoma in the United States: 1973-2009,” 2013, Jeannette R. Wong et al, Pediatrics

     

    “Pediatric Melanoma: Results of a Large Cohort Study and Proposal for Modified ABCD Detection Criteria for Children,” 2013, Kelly M. Cordoro et al, Journal of the American Academy of Dermatology

Published On: April 29, 2014