The study collected data on 123 patients (54 men and 69 women) with melanomas of plantar volar skin who received treatment at Shinshu University Hospital, Japan between January 1990 and December 2014. The mean age of the patients was 73.5 years. The melanoma occurred on the sole of the left foot in 61 patients and on the right sole in 62 patients. The diagnosis was histopathologically confirmed in all the patients, and lesions that developed primarily in the subungual and periungual areas were excluded from the analysis. The study was approved by the institutional review board at the Shinshu University School of Medicine. In conclusion, the report stated: “Although trauma and other factors increase the risk of melanoma in regions of the skin that are not exposed to the sun,we found that the conditions of the rear of the foot and front of the foot were more conducive to the development of melanomas than other areas of the plantar surface. Mechanical stress such as plantar pressure and shear stress is higher in these two areas than in other areas of the foot, and this stress is associated with the development of skin ulcers in persons with diabetes and with the development of calluses. Taken together with these observations, our results suggest that mechanical stress also increases the formation of melanomas on the plantar surface.” Per Hall, Clinical Director at Check4Cancer and a pioneer in the early detection of melanoma, comments: “Prevention and risk reduction is always the first line of defence, but it is impossible to reduce our risk of this cancer to zero, and it is not just about applying sun block. Early detection is therefore vital. As this study shows, we need to be keenly aware of our own skins, to get regular checks and report any anomalies – and just because an area of skin is not exposed to sun does not mean it is not subject to other kinds of damage. If caught early, however, the prognosis is good. “We have had a vivid demonstration of this ourselves, when implementing SkinCheck screenings for employees of the company Lend Lease. One individual had a tiny mole on the sole of his foot which he subsequently had to have removed. He had no idea it was there, and it is highly unlikely he would have caught it had this programme of screening and awareness raising not been taking place. As Gemma Bourne, Head of CSR and Lend Lease Foundation (EMEA) later told us: ‘That consultation effectively saved his life.”
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