Advertisement

Cancer Causes & Control

, Volume 3, Issue 6, pp 513–516 | Cite as

A theory of site distribution of melanomas: Queensland, Australia

  • Adèle Green
Research Paper

Although sun exposure is believed to be associated causally with cutaneous melanoma, the high incidence on less sun-exposed areas such as the back, as well as on chronically exposed sites such as the face, suggests that the association with sunlight is less straightforward than for other skin cancers. To explain this enigmatic site distribution, a theory of site-dependent susceptibility of melanocytes to malignant transformation is proposed. As possible evidence, all melanomas diagnosed in the state of Queensland, Australia, over a one-year period were surveyed for histologic evidence of benign melanocytic nevus cells adjacent to the melanoma, and analyzed according to anatomic distribution. Results showed a regional variation in the proportion of melanomas with adjacent nevi not explicable by regional variation in nevus density, which suggests that there is a varying susceptibility of nevi to malignant change. Given that nevus cells are equivalent to melanocytes, this finding would support the hypothesis that melanocytes at-large have a differential response to the mitogenic stimulus of sunlight according to anatomic site.

Key words

Australia melanoma nevi site distribution 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Koh HK. Cutaneous melanoma. N Engl J Med 1991; 325: 171–82.Google Scholar
  2. 2.
    Green A, Beardmore G, Hart V, Leslie D, Marks R, Staines D. Skin cancer in a Queensland population. J Am Acad Dermatol 1988; 19: 1045–53.Google Scholar
  3. 3.
    Pearl DK, Scott EL. The anatomic distribution of skin cancers. Int J Epidemiol 1986; 15: 502–6.Google Scholar
  4. 4.
    Newell GR, Sider JG, Bergfelt L, Kripke ML. Incidence of cutaneous melanoma in the United States by histology with special reference to the face. Cancer Res 1988; 48: 5036–41.Google Scholar
  5. 5.
    Green A, MacLennan R, Youll P, Martin N. Site distribution of cutaneous melanoma in Queensland. Int J Cancer 1992 (in press).Google Scholar
  6. 6.
    Szabo G. The regional anatomy of the human integument with special reference to the distribution of hair follicles, sweat glands and melanocytes. Philos Trans Royal Soc London 1967; 252: 447–85.Google Scholar
  7. 7.
    Crombie IK. Distribution of malignant melanoma on the body surface. Br J Cancer 1981; 43: 842–9.Google Scholar
  8. 8.
    Armstrong BK. Epidemiology of melanoma: intermittent or total accumulated exposure to the sun? J Derm Surg Oncol 1988; 14: 835–49.Google Scholar
  9. 9.
    Elwood JM, Gallagher RP, Hill GB, Pearson JCG. Cutaneous melanoma in relation to intermittent and constant sun exposure—the Western Canada melanoma study. Int J Cancer 1985; 35: 427–33.Google Scholar
  10. 10.
    Beral V, Robinson N. The relationship of malignant melanoma, basal and squamous cell skin cancers to indoor and outdoor work. Br J Cancer 1981; 44: 886–91.Google Scholar
  11. 11.
    Ross PM. Apparent absence of a benign percursor lesion: implications for the pathogenesis of malignant melanoma. J Am Acad Dermatol 1989; 21: 529–38.Google Scholar
  12. 12.
    Green A, Swerdlow AJ. Epidemiology of melanocytic nevi. Epidemiol Reviews 1989; 11: 204–21.Google Scholar
  13. 13.
    Elder D. Human melanocytic neoplasms and their etiologic relationship with sunlight. J Invest Dermatol 1989; 92: 297S-303S.Google Scholar
  14. 14.
    Clark WH, Elder DE, Guerry D, et al. A study of tumor progression: the precursor lesions of superficial spreading and nodular melanoma. Hum Pathol 1984; 15: 1147–65.Google Scholar
  15. 15.
    Stegmaier O, Becker S. Incidence of melanocytic nevi in young adults. J Invest Dermatol 1960; 34: 125–8.Google Scholar
  16. 16.
    Heenan PJ, Armstrong BK, English DR, Holman CDJ. Pathological and epidemiological variants of cutaneous malignant melanoma. Pigment Cell 1987; 8: 107–46.Google Scholar
  17. 17.
    Green A. Incidence and reporting of cutaneous melanoma in Queensland. Aust J Dermatol 1982; 23: 105–9.Google Scholar
  18. 18.
    Black WC. Residual dysplastic and other nevi in superficial spreading melanoma: clinical correlations and association with sun damage. Cancer 1988; 62: 163–73.Google Scholar
  19. 19.
    Pack GT, Lenson N, Gerber DM. Regional distribution of moles and melanomas. Arch Surg 1952; 65: 862–70.Google Scholar
  20. 20.
    Magana-Garcia M, Ackerman AB. What are nevus cells? Am J Dermatopathol 1990; 12: 93–102.Google Scholar
  21. 21.
    Jimbow K, Uesugi T. New melanogenesis and photobiological processes in activation and proliferation of precursor melanocytes after UV-exposure: ultrastructural differentiation of precursor melanocytes from Langerhans cells. J Invest Dermatol 1982; 78: 108–15.Google Scholar
  22. 22.
    Gordon PR, Mansur CP, Gilchrest BA. Regulation of human melanocyte growth, dendricity, and melanization by keratinocyte derived factors. J Invest Dermatol 1989; 92: 565–72.Google Scholar
  23. 23.
    Cristofolini M, Franceschi S, Tasin L, et al. Risk factors for cutaneous melanoma in a northern Italian population. Int J Cancer 1987; 39: 150–4.Google Scholar
  24. 24.
    Ackerman B, David K. A unifying concept of malignant melanoma: biologic aspects. Human Pathol 1986; 17: 438–40.Google Scholar

Copyright information

© Rapid Communications of Oxford Ltd 1992

Authors and Affiliations

  • Adèle Green
    • 1
  1. 1.Queensland Institute of Medical ResearchBrisbaneAustralia

Personalised recommendations