Cutaneous melanoma in children and adolescents and aspects of naevus phenotype in melanoma risk assessment

Linköping University Medical Dissertations No. 961 Cutaneous melanoma in children and adolescents and aspects of naevus phenotype in melanoma risk as...
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Linköping University Medical Dissertations No. 961

Cutaneous melanoma in children and adolescents and aspects of naevus phenotype in melanoma risk assessment Pia Karlsson

Department of Biomedicine and Surgery, Division of Dermatology Faculty of Health Sciences, Linköping University, SE-581 85 Linköping, Sweden Linköping 2006

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Printed by LiU-Tryck, Linköping, Sweden, 2006 ISBN 91-85643-73-4 ISSN 0345-0082

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To Jan, Linus and Simon with love

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”The important thing is not to stop questioning. Curiosity has its own reason for existing” A. Einstein

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ABSTRACT Cutaneous malignant melanoma (CMM) is one of the most rapidly increasing cancers in the Swedish population. The aetiology of melanoma is a complex interplay between genetics, host characteristics and environmental factors. The host characteristic with the strongest association with CMM is a phenotype with high numbers of common naevi and with dysplastic naevi. The principal environmental factor is sun exposure. Melanoma risk assessment (paper I) In a multi-national study including 986 subjects from Sweden, Denmark, the UK, Germany and the Netherlands, the ability of primary care physicians and nurses to identify individuals at increased melanoma risk was assessed. The atypical mole syndrome (AMS) scoring system for melanoma risk was used. The AMS scoring system consists of a five point check list incorporating total body naevus counts, clinically dysplastic naevi and body distribution of naevi. After brief training, the overall agreement in diagnosis between the trained personnel and experienced dermatologists was 94.5% (kappa value 0.70, p

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