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第二原发黑色素瘤:接受晒床照射的患者风险增加且发病时间提前。

Second primary melanomas: Increased risk and decreased time to presentation in patients exposed to tanning beds.

机构信息

Washington University School of Medicine, St. Louis, Missouri.

Department of Family Medicine, University of Massachusetts, Worcester, Massachusetts.

出版信息

J Am Acad Dermatol. 2018 Dec;79(6):1101-1108. doi: 10.1016/j.jaad.2018.06.067. Epub 2018 Oct 19.

Abstract

BACKGROUND

Melanoma incidence has increased; the primary modifiable risk factor is ultraviolet radiation (UVR) from the sun or artificial UVR (arUVR) from tanning beds.

OBJECTIVE

To determine whether patients who developed melanoma after arUVR exposure from tanning beds have unique characteristics.

METHODS

A retrospective study of 434 melanoma patients was performed. Patients who consented at the initial appointment completed a questionnaire regarding phenotypic traits, medical history, and UVR exposure.

RESULTS

Compared with patients aged ≥40 years, younger patients, especially women, had greater lifetime exposure to arUVR. At any age, patients with multiple primary melanomas had a higher probability of exposure to arUVR. For all patients with additional primary melanomas, those exposed to arUVR acquired their second primary melanoma significantly earlier; 67% of patients exposed to arUVR through tanning beds had their second primary diagnosed at the time of or within 1 year of their original diagnosis compared with 28% of nontanners (P = .011). Median time to diagnosis of second primary melanoma in patients exposed to arUVR versus those not exposed was 225 days versus 3.5 years, respectively (P = .027).

LIMITATIONS

The study was conducted in 1 geographic area with a relatively small sample size.

CONCLUSION

Our findings provide evidence for heightened surveillance in melanoma patients exposed to arUVR.

摘要

背景

黑色素瘤发病率上升;主要可修正风险因素是来自太阳的紫外线辐射(UVR)或晒黑床的人工 UVR(arUVR)。

目的

确定因晒黑床的 arUVR 暴露而患上黑色素瘤的患者是否具有独特特征。

方法

对 434 名黑色素瘤患者进行了回顾性研究。在首次预约时同意的患者完成了一份关于表型特征、病史和 UVR 暴露的问卷。

结果

与年龄≥40 岁的患者相比,年轻患者,尤其是女性,一生中暴露于 arUVR 的时间更长。在任何年龄,具有多个原发性黑色素瘤的患者更有可能暴露于 arUVR。对于所有具有额外原发性黑色素瘤的患者,暴露于 arUVR 的患者更早地获得了他们的第二个原发性黑色素瘤;67%的暴露于晒黑床 arUVR 的患者在原始诊断时或在原始诊断后的 1 年内被诊断出第二个原发性黑色素瘤,而非晒黑者为 28%(P=.011)。暴露于 arUVR 的患者与未暴露于 arUVR 的患者的第二个原发性黑色素瘤的诊断中位时间分别为 225 天和 3.5 年(P=.027)。

局限性

该研究在一个地理区域进行,样本量相对较小。

结论

我们的研究结果为暴露于 arUVR 的黑色素瘤患者提供了加强监测的证据。

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