Older patients, as well as those who have a history of immunosuppression, may have a higher risk of aggressive melanoma, according to a retrospective case-control study involving 141 melanoma patients.

Subjects were included if they had been followed for at least 5 years, or had documented metastases. Investigators placed them into nonaggressive or aggressive groups, and then evaluated the association of multiple clinical and histologic parameters and metastases.

In univariate analyses, significant prognostic factors linked with nonaggressive disease were history of dysplastic nevus syndrome and ABCDE criteria. The factors associated with aggressive disease were age and immunosuppression. Further, only age and immunosuppression remained significant in multivariate analysis.

The authors recommended that once clinicians diagnose melanoma in older and immunosuppressed patients, they closely monitor these individuals for aggressive disease.

Citation: Donahue T, Lee, CY, Sanghvi A, et al. Immunosuppression is an independent prognostic factor associated with aggressive tumor behavior in cutaneous melanoma. J Am Acad Dermatol. 2015;73(3):461-466.