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• W2602097178 abstract "A 3-year-old girl presented with a left shin nodule that appeared 6 months previously, and her mother had taken serial photographs of the growth and evolution (Figure). The tumor was initially thought to be mollusca, part of her concurrent infection, and later a keloid scar. Examination revealed a 1.6-cm, red, slightly friable nodule with peripheral scale. Excisional biopsy showed a severely atypical compound Spitzoid melanocytic proliferation, consistent with Spitzoid melanoma, with a Breslow depth of 3.5 mm, level IV invasion, and mitotic index of 14/mm2. Ulceration, lymphovascular invasion, and regression were not identified on histopathology. Sentinel lymph node biopsy revealed 4 of 4 positive nodes in both the inguinal and external iliac nodal basins. Subsequent completion lymphadenectomy showed no disease (0 of 15 nodes), and imaging was unremarkable. The patient is undergoing adjuvant interferon therapy, with no evidence of recurrence in 1 year of follow-up. Pediatric melanomas are rare, and can be challenging to diagnose owing to atypical clinical characteristics.1Wong J.R. Harris J.K. Rodriguez-Galindo C. Johnson K.J. Incidence of childhood and adolescent melanoma in the United States: 1973-2009.Pediatrics. 2013; 131: 846-854Crossref PubMed Scopus (120) Google Scholar, 2Mitkov M. Chrest M. Diehl N.N. Heckman M.G. Tollefson M. Jambusaria-Pahlajani A. Pediatric melanomas often mimic benign skin lesions: a retrospective study.J Am Acad Dermatol. 2016; 75 (e4): 706-711Abstract Full Text Full Text PDF PubMed Scopus (22) Google Scholar The majority of melanomas presenting in children 0-10 years of age are amelanotic, and childhood and adolescent melanomas often lack border irregularity, color heterogeneity, or diameter >6 mm.3Cordoro K.M. Gupta D. Frieden I.J. McCalmont T. Kashani-Sabet M. Pediatric melanoma: results of a large cohort study and proposal for modified ABCD detection criteria for children.J Am Acad Dermatol. 2013; 68: 913-925Abstract Full Text Full Text PDF PubMed Scopus (139) Google Scholar Modified ABCD criteria (which conventionally represent Asymmetry, Border irregularity, Color heterogeneity, and Diameter >6 mm features of pigmented lesions that should prompt evaluation in adults) have been proposed for recognizing melanoma in children, and these include amelanosis, bleeding, “bumps,” uniform color, variable diameter, and de novo development.3Cordoro K.M. Gupta D. Frieden I.J. McCalmont T. Kashani-Sabet M. Pediatric melanoma: results of a large cohort study and proposal for modified ABCD detection criteria for children.J Am Acad Dermatol. 2013; 68: 913-925Abstract Full Text Full Text PDF PubMed Scopus (139) Google Scholar Evolution is also a predominant feature among childhood melanoma, and timely dermatologic referral is recommended for lesions of any color or shape that are reported to be rapidly growing, bleeding, or otherwise changing.2Mitkov M. Chrest M. Diehl N.N. Heckman M.G. Tollefson M. Jambusaria-Pahlajani A. Pediatric melanomas often mimic benign skin lesions: a retrospective study.J Am Acad Dermatol. 2016; 75 (e4): 706-711Abstract Full Text Full Text PDF PubMed Scopus (22) Google Scholar, 3Cordoro K.M. Gupta D. Frieden I.J. McCalmont T. Kashani-Sabet M. Pediatric melanoma: results of a large cohort study and proposal for modified ABCD detection criteria for children.J Am Acad Dermatol. 2013; 68: 913-925Abstract Full Text Full Text PDF PubMed Scopus (139) Google Scholar We endorse home photodocumentation, which has been used previously to assess superficial infantile hemangioma growth, for monitoring and evaluating pediatric cutaneous conditions.4Tollefson M.M. Frieden I.J. Early growth of infantile hemangiomas: what parents' photographs tell us.Pediatrics. 2012; 130: e314-20Crossref PubMed Scopus (136) Google Scholar This approach provides more information than can be obtained in office visits alone, and photographs demonstrating dramatic evolution over several months may prompt biopsy at an initial dermatology visit—leading to earlier diagnosis of aggressive tumors. In this case, parental photodocumentation meaningfully contributed to evaluation of a rare, challenging tumor." @default.
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• W2602097178 date "2017-07-01" @default.
• W2602097178 modified "2023-09-26" @default.
• W2602097178 title "Evolving Childhood Melanoma Monitored by Parental Photodocumentation" @default.
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• W2602097178 doi "https://doi.org/10.1016/j.jpeds.2017.02.075" @default.
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