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High Risk of Malignant Melanoma in Melanoma-Prone Families with Dysplastic Nevi

MARK H. GREENE, M.D.; WALLACE H. CLARK Jr., M.D.; MARGARET A. TUCKER, M.D.; KENNETH H. KRAEMER, M.D.; DAVID E. ELDER, M.B., Ch.B.; and MARY C. FRASER, R.N., M.A.
[+] Article and Author Information

Grant support: in part by research grants CA 16520, CA 25298, and CA 25874 from the National Cancer Institute, and by contract N01-CP-01054 with the National Institutes of Health.

▸Requests for reprints should be addressed to Mark H. Greene, M.D.; Environmental Epidemiology Branch, National Cancer Institute, Landow 3C-29; Bethesda, MD 20205.


Bethesda, Maryland; and Philadelphia, Pennsylvania


Ann Intern Med. 1985;102(4):458-465. doi:10.7326/0003-4819-102-4-458
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The risk of hereditary cutaneous malignant melanoma was evaluated in 401 members of 14 families with an autosomal dominant form of melanoma. We documented 127 primary melanomas in 69 family members, including 39 new melanomas diagnosed in 22 study participants from the time of first examination through a maximum of 8 years of follow-up. The 39 newly diagnosed melanomas occurred only in family members with dysplastic nevi, a known precursor of familial melanoma. Of 77 patients with dysplastic nevus syndrome without prior melanomas, 4 developed their first melanoma during prospective follow-up, as compared with 0.03 cases expected. The prospective age-adjusted incidence for melanoma was 14.3/1000 patients with dysplastic nevus per year, with a cumulative melanoma risk (±SE) of 7.2% (±3.6) at 8 years. The actuarial probability of melanoma developing in family members with dysplastic nevi was 56.0% (±10.1) from age 20 to age 59. This study confirms that dysplastic nevi are clinical markers of high risk for, and precursors of, hereditary melanoma.

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