Can children get melanoma?
Description of the natural history of ultra-rare paediatric tumours
Skin melanoma in children is very rare: out of 1.1 million children under the age of 4, less than 1 will be diagnosed with melanoma. For children under the age of 10, the number of melanoma cases has been stable over the years. However, between the ages of 15-19, already about 10 children out of 1 million will be diagnosed, and that rate has been increasing about 2% per year for the last 20 years. Most recently, the increase seems to slow-down but it is still a worrisome trend.
Similar as it happens in adults, a child with fair or freckled skin, many odd shaped or a few large moles, a family history of melanoma and blistering sun burns has a higher risk of getting melanoma. Spitzoid melanoma is a melanoma typical for childhood and sometimes childhood melanomas look like warts or crusty spots which may or may not bleed, and they can grow very fast. Melanoma in children does not always follow the classic ABCDE rule so often described for adults. Unfortunately, this can lead to a belated diagnosis.
Some specific rare conditions can increase the risk of a child having melanoma – xeroderma pigmentosum, a DNA repair defect, giant congenital melanocytic nevi, especially when these are large and/ or numerous or children with a suppressed immune system, e.g. after an organ transplant. All children with an increased risk for melanoma should have regular check-ups with a paediatric dermatologist.
For these reasons, children should ideally be seen by a specialist in paediatric dermatology. To confirm melanoma, a biopsy (piece of tissue) needs to be taken and analyzed under a microscope, ideally by an experienced pathologist who is also familiar with childhood melanoma.
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