RISK OF DEVELOPING MULTIPLE PRIMARY CUTANEOUS MELANOMAS IN PATIENTS WITH THE CLASSIC ATYPICAL-MOLE SYNDROME - A CASE-CONTROL STUDY

The classic atypical-mole syndrome (CAMS) and/or a history of malignan t melanoma (MM) increases the risk for multiple melanomas. Case notes of 118 CAMS and 173 control patients, each with a history of MM, were reviewed for the occurrence of second primary MMs. The mean (+/- SD) a ge at diagnosis of the first MM was 38.8 +/- 12.8 and 48.9 +/- 14.7 ye ars (P < 0.001) for CAMS cases and controls, respectively, Thirty-two of 118 CAMS and 18 of 173 controls developed second primary MMs, for a cumulative 10-year life-table risk of 35.5% and 17.0%, respectively ( P < 0.0001). The mean number of months from the time of diagnosis of t he first to the second MM was 33.9 +/- 41.8 and 58.6 +/- 57.3 months f or the CAMS and controls, respectively (P = 0.08). In both cohorts the second MMs were significantly thinner, compared with the first MMs, T he relative risk (RR) for developing second MMs for CAMS patients was 3.2. The RR for the CAMS cohort compared with a matched population fro m the United States' Statistics, Epidemiology, End Results data base w as 337, and for the controls the RR was 84. All patients with MMs are at significant risk for developing multiple MMs; the risk is greater f or patients with CAMS, Periodic total cutaneous examinations are indic ated for life in an attempt to identify new MMs when they are thin.