By Gary M. White, MD
Melanoma in children (pediatric melanoma PM) is rare, but when it does occur, it tends to present late. Sometimes adolescents' reticence about showing their bodies to their parents can cause a delay in seeking medical attention [BJD 1997;136;137]. When melanoma occurs in those under 20, it usually develops after puberty, that is after age 12. Thus, the incidence of melanoma in children under 12 is quite low. Melanoma in children may occur in association with large congenital nevi and neurocutaneous melanosis. Spitz Nevus is a key differential for pediatric melanoma.
Prepubertal melanoma is very rare but when it does occur, it's more likely to arise de novo (i.e., not from a preexisting mole), be amelanotic, have only one color, and bleed. Melanomas in children 13 and older tend to appear more like the typical adult melanoma. PM may be benign-appearing, and in that situation, the history of bleeding and/or ulceration should prompt the consideration of a biopsy.
The prognosis is better for childhood than adult melanoma.
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