Causal relationship between exposure to chemicals and malignant melanoma? A review and study proposal.

Malignant melanoma (MM) is a significant cause of morbidity and mortality worldwide. The MM-related incidence and mortality have been increasing at an alarming rate over at least the past four decades. Malignant melanoma has been thought to be related mainly to exposure to the sun or UV radiation. A review of the scientific literature reveals many significant correlations between chemical exposure in the workplace and the occurrence of malignant melanoma, particularly in cutaneous areas that have never been exposed to sunlight. Discrepant findings are reported by independent studies concluding that MM is causally related to employment-related chemical exposures and to investigators with industry affiliations. More studies are needed to define a correlation of chemical exposure as a co-factor on the pathogenesis in some melanoma patients. We propose further investigation by dermatologists working in Melanoma Centers, using a simple questionnaire on chemical exposure among patients, that have previously been diagnosed and are followed up for melanoma comparing with appropriate matched controls. Collecting the data and results from the questionnaire will help us understand the initiation events in melanoma and prevention health issues.