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Melanoma more aggressive in patients with fewer moles

People who have fewer moles may be at risk for being diagnosed with more aggressive melanoma than those with a greater amount of moles, according to research presented by Dr. Caroline Kim at the American Academy of Dermatology’s 2015 Summer Academy Meeting in New York.

Patients with more than 50 moles may be more aware of their skin cancer risk and more likely to visit the dermatologist for screenings, however, Dr. Kim cautions that through her experience treating advanced-stage melanoma cases, she has observed that patients with fewer moles tended to have more aggressive melanoma than those with many moles.

Dr. Kim is the director at Pigmented Lesion Clinic and an associate director of cutaneous oncology program at Beth Israel Deaconess Medical Center (BIDMC) in the Department of Dermatology at Harvard Medical School in Boston, Mass.

Patients with more than 50 moles were diagnosed at a younger age

To investigate the differences in melanoma between these two groups, Dr. Kim and her colleagues reviewed the charts of 281 melanoma patients who visited BIDMC in 2013 and 2014. Eighty-nine of these patients had more than 50 moles, while the remaining 192 had fewer than 50 moles.

As Dr. Kim suspected, patients with fewer moles had thicker, more aggressive melanoma than those with many moles. The tendency toward thinner, less aggressive melanoma was observed in patients with both a high number of moles and atypical moles, another melanoma risk factor.

According to researchers, data also showed that those with more than 50 moles were more likely to be diagnosed with melanoma at a younger age than those with fewer moles.

Possible attributing factors

Dr. Kim says the results of their research could be attributable to several factors. Health care providers may readily identify patients with more than 50 moles as being at risk for melanoma and educate those patients regarding that risk. As a result, patients with many moles may be more likely to visit a dermatologist for regular skin exams, allowing for their melanoma to be detected at an earlier stage, when it is thinner and less aggressive.

Additionally, there are biologic differences between patients with many moles and those with few moles, Dr. Kim says, and these differences may be responsible for the variations in melanoma between the two groups.

“We already know that melanomas are not all the same genetically,” said Dr. Kim, who was quoted in a press release.

“It is possible that there are different pathways that drive melanoma in these two patient groups, resulting in different degrees of aggressiveness. If patients with fewer moles are more prone to aggressive melanoma, then we need to make sure that they are also being educated and screened, in addition to patients with many moles.”

Additional large-scale studies are needed to confirm the results of their research, concluded Dr. Kim.

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