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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p class="elsevierStyleSimplePara elsevierViewall">Melanomas arising in areas with comparable levels of sun exposure have been shown to have similar genetic profiles&#46; The aim of this study was to characterize the clinical features of melanoma patients according to the pattern of sun exposure&#58; chronic&#44; intermittent&#44; or none&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p class="elsevierStyleSimplePara elsevierViewall">From our melanoma database&#44; we selected 789 consecutive patients with melanoma diagnosed in our center since January 2000&#46; Epidemiologic data&#44; phenotype&#44; and personal and family history of cancer were retrieved&#46; The observed frequency of each variable was compared&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Most melanoma patients presented tumors on areas exposed intermittently to sunlight&#46; In addition&#44; these patients presented higher numbers of common and atypical melanocytic <span class="elsevierStyleItalic">nevi</span> and the melanoma very frequently arose in a pre-existing <span class="elsevierStyleItalic">nevus</span>&#46; The second largest group was formed by patients with tumors on areas chronically exposed to sun and that had all the clinical lesions &#40;solar lentigines and actinic keratoses&#41; and epidemiologic characteristics typical of these areas&#46; Finally&#44; patients with melanomas on areas not exposed to sun were older&#44; as occurred in the group with chronic exposure&#44; and the diagnosis was made at more advanced stages of the disease&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">There are many patients who did not fit these patterns of melanoma development&#46; Clinical and biological characterization is therefore necessary to determine alternative pathways of development in order to establish specific preventive measures&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha observado que los melanomas tienen un perfil gen&#233;tico similar seg&#250;n el patr&#243;n de exposici&#243;n al sol del &#225;rea cut&#225;nea donde asientan&#46; El objetivo de este estudio ha sido caracterizar desde el punto de vista cl&#237;nico los pacientes con melanoma seg&#250;n su patr&#243;n de exposici&#243;n al sol&#58; cr&#243;nico&#44; intermitente y ausencia de exposici&#243;n&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se seleccionaron 789 pacientes con melanoma diagnosticados en nuestro centro de forma consecutiva desde enero del a&#241;o 2000 a partir de la base de datos de melanoma&#46; Se obtuvieron los datos referentes a las caracter&#237;sticas epidemiol&#243;gicas&#44; fenot&#237;picas y los antecedentes personales y familiares de c&#225;ncer&#46; Se compararon las frecuencias observadas de cada una de las variables estudiadas&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se observ&#243; que la mayor&#237;a de los pacientes tienen los melanomas en localizaciones expuestas al sol de forma intermitente&#46; Adem&#225;s&#44; estos pacientes tienen m&#225;s nevus melanoc&#237;ticos tanto comunes como at&#237;picos y su melanoma se asocia con una elevada frecuencia a un nevus preexistente&#46; Por otra parte&#44; el segundo grupo en n&#250;mero est&#225; constituido por el grupo de pacientes con melanomas en &#225;reas cut&#225;neas expuestas al sol de forma cr&#243;nica que presentaron todas las lesiones &#40;lentigos solares y queratosis act&#237;nicas&#41; y antecedentes t&#237;picos de esta localizaci&#243;n&#46; Finalmente&#44; el grupo de melanomas que se presenta en &#225;reas de piel no expuestas al sol tiene&#44; al igual que el anterior&#44; una edad de diagn&#243;stico mayor y se diagnostican en fases avanzadas de la enfermedad&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La presencia de un elevado n&#250;mero de pacientes que no sigue ninguno de los patrones mencionados suscita la necesidad de caracterizarlos cl&#237;nica y biol&#243;gicamente para conocer v&#237;as alternativas de desarrollo de un melanoma&#44; y as&#237; poder establecer medidas preventivas adecuadas&#46;</p>"
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                    0 => array:2 [
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                            0 => "A&#46;N&#46; Crowson"
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                            2 => "R&#46;L&#46; Barnhill"
                            3 => "M&#46;C&#46; Mihm Jr"
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                      "titulo" => "Gene amplifications characterize acral melanoma and permit the detection of occult tumor cells in the surrounding skin"
                      "autores" => array:1 [
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                          "etal" => true
                          "autores" => array:6 [
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                            2 => "H&#46; Hamm"
                            3 => "T&#46; Godfrey"
                            4 => "D&#46;H&#46; Moore 2nd"
                            5 => "E&#46;B&#46; Br&#246;cker"
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                        "tituloSerie" => "Cancer Res"
                        "fecha" => "2000"
                        "volumen" => "60"
                        "paginaInicial" => "1968"
                        "paginaFinal" => "1973"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10766187"
                            "web" => "Medline"
                          ]
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                            3 => "A&#46;N&#46; Jain"
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                            5 => "T&#46; Kageshita"
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                        "tituloSerie" => "J Natl Cancer Inst"
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                        "paginaFinal" => "1890"
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                            5 => "O&#46; Lavie"
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                        ]
                      ]
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                      "Revista" => array:5 [
                        "tituloSerie" => "Clin CancerRes"
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                        "paginaFinal" => "3447"
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                            3 => "H&#46;N&#46; Patel"
                            4 => "K&#46;J&#46; Busam"
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                ]
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                      "titulo" => "Meta-analysis of risk factors for cutaneous melanoma&#58; I&#46; Common and atypical naevi"
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                            2 => "M&#46;S&#46; Cattaruzza"
                            3 => "P&#46; Pasquini"
                            4 => "D&#46; Abeni"
                            5 => "P&#46; Boyle"
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                        "volumen" => "41"
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                        "paginaFinal" => "44"
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              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of melanoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46; Marks"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Dermatol"
                        "fecha" => "2000"
                        "volumen" => "25"
                        "paginaInicial" => "459"
                        "paginaFinal" => "463"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11044179"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Childhood sun exposure as a risk factor for melanoma&#58; a systematic review of epidemiologic studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46;C&#46; Whiteman"
                            1 => "C&#46;A&#46; Whiteman"
                            2 => "A&#46;C&#46; Green"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Causes Control"
                        "fecha" => "2001"
                        "volumen" => "12"
                        "paginaInicial" => "69"
                        "paginaFinal" => "82"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11227927"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sun exposure&#44; pigmentary traits&#44; and risk of cutaneous malignant melanoma&#58; a case-control study in a Mediterranean population"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;M&#46; Rodenas"
                            1 => "M&#46; Delgado-Rodr&#237;guez"
                            2 => "M&#46;T&#46; Herranz"
                            3 => "J&#46; Tercedor"
                            4 => "S&#46; Serrano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Causes Control"
                        "fecha" => "1996"
                        "volumen" => "7"
                        "paginaInicial" => "275"
                        "paginaFinal" => "283"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8740740"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meta-analysis of risk factors for cutaneous melanoma&#58; II&#46; Sun exposure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Gandini"
                            1 => "F&#46; Sera"
                            2 => "M&#46;S&#46; Cattaruzza"
                            3 => "P&#46; Pasquini"
                            4 => "O&#46; Picconi"
                            5 => "P&#46; Boyle"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejca.2004.10.016"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cancer"
                        "fecha" => "2005"
                        "volumen" => "41"
                        "paginaInicial" => "45"
                        "paginaFinal" => "60"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15617990"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous melanoma histologically associated with a nevus and melanoma de novo have a different profile of risk&#58; results from a case-control study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46; Carli"
                            1 => "D&#46; Massi"
                            2 => "M&#46; Santucci"
                            3 => "A&#46; Biggeri"
                            4 => "B&#46; Giannotti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "1999"
                        "volumen" => "40"
                        "paginaInicial" => "549"
                        "paginaFinal" => "557"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10188672"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Do all melanomas come from &#171;moles&#187;&#63; A study of the histological association between melanocytic naevi and melanoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Marks"
                            1 => "A&#46;P&#46; Dorevitch"
                            2 => "G&#46; Mason"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Australas J Dermatol"
                        "fecha" => "1990"
                        "volumen" => "31"
                        "paginaInicial" => "77"
                        "paginaFinal" => "80"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2095738"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High frequency of BRAF mutations in nevi"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46;M&#46; Pollock"
                            1 => "U&#46;L&#46; Harper"
                            2 => "K&#46;S&#46; Hansen"
                            3 => "L&#46;M&#46; Yudt"
                            4 => "M&#46; Stark"
                            5 => "C&#46;M&#46; Robbins"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/ng1054"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nat Genet"
                        "fecha" => "2003"
                        "volumen" => "33"
                        "paginaInicial" => "19"
                        "paginaFinal" => "20"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12447372"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "p53 expression and risk factors for cutaneous melanoma&#58; a case-control study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46;C&#46; Whiteman"
                            1 => "P&#46;G&#46; Parsons"
                            2 => "A&#46;C&#46; Green"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Cancer"
                        "fecha" => "1998"
                        "volumen" => "77"
                        "paginaInicial" => "843"
                        "paginaFinal" => "848"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9714052"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
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Vol. 100. Issue 3.
Pages 205-211 (April 2009)
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Vol. 100. Issue 3.
Pages 205-211 (April 2009)
Original article
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Clinical and Epidemiologic Profile of Melanoma Patients According To Sun Exposure Of The Tumor Site
Perfil Clínico y Epidemiológico de los Pacientes con Melanoma Cutáneo Según el Grado de Exposición Solar de la Localización del Melanoma
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E. Nagore
Corresponding author
eduyame@meditex.es

Correspondence: Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, C/ Profesor Beltrán Báguena 8, 46009 Valencia, Spain.
, R. Botella-Estrada, C. Requena, C. Serra-Guillén, A. Martorell, L. Hueso, B. Llombart, O. Sanmartín, C. Guillén
Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
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Abstract
Introduction

Melanomas arising in areas with comparable levels of sun exposure have been shown to have similar genetic profiles. The aim of this study was to characterize the clinical features of melanoma patients according to the pattern of sun exposure: chronic, intermittent, or none.

Material and methods

From our melanoma database, we selected 789 consecutive patients with melanoma diagnosed in our center since January 2000. Epidemiologic data, phenotype, and personal and family history of cancer were retrieved. The observed frequency of each variable was compared.

Results

Most melanoma patients presented tumors on areas exposed intermittently to sunlight. In addition, these patients presented higher numbers of common and atypical melanocytic nevi and the melanoma very frequently arose in a pre-existing nevus. The second largest group was formed by patients with tumors on areas chronically exposed to sun and that had all the clinical lesions (solar lentigines and actinic keratoses) and epidemiologic characteristics typical of these areas. Finally, patients with melanomas on areas not exposed to sun were older, as occurred in the group with chronic exposure, and the diagnosis was made at more advanced stages of the disease.

Conclusions

There are many patients who did not fit these patterns of melanoma development. Clinical and biological characterization is therefore necessary to determine alternative pathways of development in order to establish specific preventive measures.

Key words:
melanoma
sun exposure
epidemiology
Palabras clave:
melanoma
exposición solar
epidemiología
Resumen
Introducción

Se ha observado que los melanomas tienen un perfil genético similar según el patrón de exposición al sol del área cutánea donde asientan. El objetivo de este estudio ha sido caracterizar desde el punto de vista clínico los pacientes con melanoma según su patrón de exposición al sol: crónico, intermitente y ausencia de exposición.

Material y métodos

Se seleccionaron 789 pacientes con melanoma diagnosticados en nuestro centro de forma consecutiva desde enero del año 2000 a partir de la base de datos de melanoma. Se obtuvieron los datos referentes a las características epidemiológicas, fenotípicas y los antecedentes personales y familiares de cáncer. Se compararon las frecuencias observadas de cada una de las variables estudiadas.

Resultados

Se observó que la mayoría de los pacientes tienen los melanomas en localizaciones expuestas al sol de forma intermitente. Además, estos pacientes tienen más nevus melanocíticos tanto comunes como atípicos y su melanoma se asocia con una elevada frecuencia a un nevus preexistente. Por otra parte, el segundo grupo en número está constituido por el grupo de pacientes con melanomas en áreas cutáneas expuestas al sol de forma crónica que presentaron todas las lesiones (lentigos solares y queratosis actínicas) y antecedentes típicos de esta localización. Finalmente, el grupo de melanomas que se presenta en áreas de piel no expuestas al sol tiene, al igual que el anterior, una edad de diagnóstico mayor y se diagnostican en fases avanzadas de la enfermedad.

Conclusiones

La presencia de un elevado número de pacientes que no sigue ninguno de los patrones mencionados suscita la necesidad de caracterizarlos clínica y biológicamente para conocer vías alternativas de desarrollo de un melanoma, y así poder establecer medidas preventivas adecuadas.

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References
[1.]
A.N. Crowson, C.M. Magro, R.L. Barnhill, M.C. Mihm Jr.
Pathology.
Cutaneous melanoma, 4th ed, pp. 171-208
[2.]
B.C. Bastian, M. Kashani-Sabet, H. Hamm, T. Godfrey, D.H. Moore 2nd, E.B. Bröcker, et al.
Gene amplifications characterize acral melanoma and permit the detection of occult tumor cells in the surrounding skin.
Cancer Res, 60 (2000), pp. 1968-1973
[3.]
J.L. Maldonado, J. Fridlyand, H. Patel, A.N. Jain, K. Busam, T. Kageshita, et al.
Determinants of BRAF mutations in primary melanomas.
J Natl Cancer Inst, 95 (2003), pp. 1878-1890
[4.]
Y. Cohen, E. Rosenbaum, S. Begum, D. Goldenberg, C. Esche, O. Lavie, et al.
Exon 15 BRAF mutations are uncommon in melanomas arising in non-sun-exposed sites.
Clin CancerRes, 10 (2004), pp. 3444-3447
[5.]
J.A. Curtin, J. Fridlyand, T. Kageshita, H.N. Patel, K.J. Busam, H. Kutzner, et al.
Distinct sets of genetic alterations in melanoma.
N Engl J Med, 353 (2005), pp. 2135-2147
[6.]
S. Gandini, F. Sera, M.S. Cattaruzza, P. Pasquini, D. Abeni, P. Boyle, et al.
Meta-analysis of risk factors for cutaneous melanoma: I. Common and atypical naevi.
Eur J Cancer, 41 (2005), pp. 28-44
[7.]
D.C. Whiteman, P. Watt, D.M. Purdie, M.C. Hughes, N.K. Hayward, A.C. Green.
Melanocytic nevi, solar keratoses, and divergent pathways to cutaneous melanoma.
J Natl Cancer Inst, 95 (2003), pp. 806-812
[8.]
R. Marks.
Epidemiology of melanoma.
Clin Exp Dermatol, 25 (2000), pp. 459-463
[9.]
D.C. Whiteman, C.A. Whiteman, A.C. Green.
Childhood sun exposure as a risk factor for melanoma: a systematic review of epidemiologic studies.
Cancer Causes Control, 12 (2001), pp. 69-82
[10.]
J.M. Rodenas, M. Delgado-Rodríguez, M.T. Herranz, J. Tercedor, S. Serrano.
Sun exposure, pigmentary traits, and risk of cutaneous malignant melanoma: a case-control study in a Mediterranean population.
Cancer Causes Control, 7 (1996), pp. 275-283
[11.]
S. Gandini, F. Sera, M.S. Cattaruzza, P. Pasquini, O. Picconi, P. Boyle, et al.
Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure.
Eur J Cancer, 41 (2005), pp. 45-60
[12.]
P. Carli, D. Massi, M. Santucci, A. Biggeri, B. Giannotti.
Cutaneous melanoma histologically associated with a nevus and melanoma de novo have a different profile of risk: results from a case-control study.
J Am Acad Dermatol, 40 (1999), pp. 549-557
[13.]
R. Marks, A.P. Dorevitch, G. Mason.
Do all melanomas come from «moles»? A study of the histological association between melanocytic naevi and melanoma.
Australas J Dermatol, 31 (1990), pp. 77-80
[14.]
P.M. Pollock, U.L. Harper, K.S. Hansen, L.M. Yudt, M. Stark, C.M. Robbins, et al.
High frequency of BRAF mutations in nevi.
Nat Genet, 33 (2003), pp. 19-20
[15.]
D.C. Whiteman, P.G. Parsons, A.C. Green.
p53 expression and risk factors for cutaneous melanoma: a case-control study.
Int J Cancer, 77 (1998), pp. 843-848
Copyright © 2009. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
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