Clinical and pathological melanoma differences in young and old people

Abstract

BACKGROUND: Melanoma is often misdiagnosed in older people. Some clinical and histopathological features seem to differ according to age. OBJECTIVES: This case series aimed to identify clinicopathological differences of melanoma between older and younger patients. METHODS: We identified all incident melanomas diagnosed in a dermatology outpatients unit from January/2007 to December/2014. Data were collected from medical records and pathology registries. RESULTS: We included 62 patients (mean age of 62.1 ± 4.2 years), with a median Breslow thickness of 4 mm (1.2 − 6.5). While men were majority in the older group, women prevailed between younger counterparts (p = 0.02). Multivariate analysis identified history of chronic sun exposure, multiple naevi, skin phototypes 1 and 2, in situ melanoma and the presence of another skin tumour to be correlated with age. In a logistic regression model, the presence of chronic sun exposure and nodular subtype were found to influence age. Major limitations include those inherent to cross ‑sectional design, including selection and information biases, the lack of confounding factors analysis (including survival and prognosis), and the sample size. CONCLUSIONS: On this case series, melanoma seems to be more frequent in older men and in elders with chronic sun exposure; age was found to be significantly related to nodular subtype and chronic sun exposure.