Other Risk Factors

A few diseases and conditions other than UV light exposure have been associated with increased risk of melanoma:

Patients with dysplastic nevi (sporadic) have a 10% lifetime risk of developing melanoma, and a 20-fold increased risk over the general population. These melanomas may arise in dysplastic nevi or de novo.

Surgical Oncology, edited by David N. Krag. ©2000 Landes Bioscience.

Table 2.1. Characteristics of ultraviolet light

Wavelength

Characteristics

UVA 320-400 nm

penetrates deeper (dermis) and may be responsible for changes of aging; may play a role in carcinogenesis

UVB 290-320 nm

responsible for sunburn and melanin production; probably the most important for carcinogenesis

200-290 nm should be completely absorbed by the ozone

200-290 nm should be completely absorbed by the ozone

Dysplastic nevus syndrome (B-K mole syndrome, or atypical mole syndrome) is often associated with a family history of melanoma, and when that does occur, the patient has approximately a 100% lifetime risk of melanoma.

Congenital nevi can be characterized as small (< 1.5 cm), medium (1.5-20 cm), or large (> 20 cm). The large congenital nevi have the strongest correlation with increased risk of melanoma, 5-20% lifetime risk. These nevi have an irregular surface, variation in color especially brown, and hypertrichosis. Malignant transformation of these lesions has been reported during childhood.

A familial predisposition is recognized and is thought to be a genetic risk that is modulated by environmental factors. Patients with a family predisposition have a 8-12% chance of cutaneous melanoma. Some have reported evidence of autosomal dominant inheritance with variable penetrance. Patients with a history of previous melanoma have at least a 10-fold increase risk of a subsequent melanoma.

Screening for Melanoma

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