Scalp Melanoma: A High-Risk Subset of Cutaneous Head and Neck Melanomas with Distinctive Clinicopathological Features

This study identifies scalp melanomas (SM) as a high-risk subset of cutaneous head and neck melanomas (CHNM), with distinct clinicopathological features and poorer survival outcomes. Among 152 CHNM patients, 35 (23%) had SM, which were more often of the superficial spreading and nodular subtypes, with a thicker Breslow index and higher tumor mitotic rate. SM patients faced a higher risk of recurrence and melanoma-specific death, with scalp location being a significant prognostic factor for recurrence and tumor mitotic rate for survival. The study stresses the importance of routine scalp examinations, particularly in older men with chronic sun exposure, and suggests involving professionals like hairdressers in early detection efforts. Limitations include a small sample size and lack of genetic data, indicating a need for future research to include genetic studies to better understand SM's poor prognosis.