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In addition to environmental insults, family history represents a significant risk factor for malignant melanoma. Melanoma is associated with a complex genetic heterogeneity, with cyclin-dependent kinase inhibitor 2A (CDKN2A or p16) and melanocortin-1 receptor (MC1R) gene mutations contributing to melanoma risk. In this case report, Eliason et al describe a patient from a familial melanoma pedigree with 7 primary melanomas on the right side of her body, the first occurring 5 years after atmospheric testing in the 1950s during which that side of her body was exposed to ionizing radiation. Genetic testing revealed deleterious homozygous CDKN2A and MC1R mutations. In this case, multiple primary melanomas were likely the result of environmental exposures superimposed on a highly vulnerable genetic predisposition.
Multiple Primary Melanomas in a CDKN2A Mutation Carrier Exposed to Ionizing Radiation. Arch Dermatol. 2007;143(11):1365. doi:10.1001/archderm.143.11.1365
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