RISK FACTORS FOR DEVELOPMENT OF SINGLE OR MULTIPLE PRIMARY MELANOMAS

  •  Male sex

  • Age>60 years

  •  Phenotypic predisposition

  • Atypical mole/dysplastic nevus pattern

  •  Increased mole count (particularly large nevi)

  •  Sun-phenotype/tendency to sunburn

  • Red hair-blue eyes/Fitzpatrick skin type I/pheomelanin predominant phenotype

Personal medical history/comorbidities

  • Multiple and/or blistering sunburns

  • Precancer/cancers, especially:

    • Actinic keratosis/non-melanoma (keratinocyte) skin cancer (eg, basal cell and squamous cell carcinomas)

    • Childhood cancer

  • Immunosuppression/immune perturbation related to:

    • Solid organ transplantation

    • Hematopoietic cell transplantation (HCT)

    • Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)

  •  Rare genodermatoses

    • Xeroderma pigmentosum
Genetic predisposition
  • Presence of germline mutations or polymorphisms predisposing to melanoma (including CDKN2a, CDK4, MC1R, BAP1, and potentially other genes).
  • Family history of cutaneous melanoma (especially if multiple), pancreatic cancer, astrocytoma, uveal melanoma, and/or mesothelioma.
 Environmental factors
  • Tanning bed use
  • Residence in sunnier climate/latitude nearer to equator
  •  Intermittent, intense sun exposure (for truncal/extremity melanomas, often observed with associated increased nevus count)
  • Chronic sun exposure (for head/neck/arm melanomas, often associated with lower nevus count)