Childhood, or pediatric melanoma is when melanoma occurs under the age of 18 years of age. Unlike melanoma in adults, which is often linked to years of exposure to UV light, pediatric melanoma in children is typically not associated with sun exposure. Instead, children with certain types of moles, such as large congenital melanocytic nevi (dark brown-black birthmarks), It is uncommon and has some unique differences from melanoma in adults.  

The risk of melanoma depends on the size of your child’s congenital mole or birthmark. Small moles or birthmarks are termed small congenital nevus. They  have a very low risk of turning into a melanoma. Giant congenital nevi are dark brown to black birthmarks that are > 20 cm in diameter. Children with giant congenital nevi are at a 15% risk of developing melanoma by the age of 10. 

Giant congenital nevi are at an elevated risk of progressing into melanoma if the child has neurocutaneous melanosis. This is a condition that occurs in 5-10% of children with giant congenital nevi where melanocytes also grow in the brain and spinal cord, resulting in neurological symptoms.   

However, preventive removal of giant congenital nevi does not seem to reduce the risk of developing melanoma. For children with large congenital moles, it is important to have regular skin examinations for melanoma with a dermatologist. It is also important to ensure your child is wearing adequate sun protection with any exposure to the sun.  

 What are some warning signs?

When assessing moles or skin spots in children, it’s helpful to remember the ABCDEs:

ASYMMETRY

The two halves of the mole have different shapes.

BORDER

The edge of the mole is irregular. It may look blurred, ragged, or notched. Pigment may spread into the skin around the mole.

COLOUR

The colour of the mole is uneven. The mole may have different shades of tan, brown, and black, sometimes with blue, gray, red, pink, or white.

DIAMETER

While melanomas are usually greater than 6 mm (the size of a pencil eraser) when diagnosed, they can be smaller.

EVOLUTION

The mole has changed in the past few weeks or months. It may be itchy, scaling or bleeding.

If you notice one or more of the following ABCDE’s below, please speak to you health care provider. 

In addition to the ABCDEs, be mindful of firm and elevated nodules or moles that continually bleed. While skin-colored and red lesions may not resemble typical melanomas, they are still a cause for concern, especially in children aged 10 and under. 


What are some risk factors? 

There are a number of risk factors that can increase a child’s risk for pediatric melanoma:

  • Giant congenital nevi 
  • Immunocompromised or immunodeficiency (immune disorder or on medication that suppresses the immune system) 
  • Xeroderma pigmentosum, a rare skin condition in which an individual as an extreme sensitivity to sunlight 
  • History of retinoblastoma (a kind of eye cancer)
  • Many moles 
  • Fair skin complexion  (light skin tones that burn easily, difficult to tan, freckles) 
  • Family history of a 1st degree relative with Dysplastic Nevus Syndrome. This is a syndrome where a person has 50 or more very oddly shaped moles. 
  • Family history of melanoma [Harlyruk]
  • Werner syndrome (a rare progressive disorder that is characterized by the appearance of unusually accelerated aging)
  • Blonde or red hair
  • Blue or other light-colored eyes


What can you do as a parent/guardian/caregiver? 

  • Care for the caregiver : Seek support as a caregiver [Gise]: Parents with children who have cancers in general often engage in less social support seeking during this difficult period. However, those who do engage in social support have reportedly improved well-being, as well as reduced anxiety, distress and posttraumatic stress. The most common social supports are other family members or partners. 
  • Care for the child : Encourage adequate nutrition [Arpaci]: Most children with systemic cancer experience at least 1 nutritional problem; for example, loss of appetite, nausea, vomiting. Encourage open dialogue with your provider on type and frequency of nutritional intake. 
  • Preventative Measure for the child : A prior history of melanoma increases the risk of developing another melanoma later in life.  Practice sun safety measures such as reducing being outside during peak sun hours (1-3pm), regularly wearing sunscreen with at least SPF30 applied every 2 hours, and covering up with hats, clothing and sunglasses.

Questions?

Call Melanoma Canada’s certified cancer coach 1.877.560.8035 x 108 or send an email to support@melanomacanada.ca