Flemming and Ruggins, in 1985, told of a 23-month-old boy with what they claimed was a melanoma on the right cheek.³⁴ Based on our own assessment of the clinical features and the histopathologic findings, this child had a Spitz's nevus and not a melanoma. There was no evidence of metastasis.

By searching the files of six hospitals during the years 1954 and 1977 and by utilizing 10 U.S. population-based Surveillance, Epidemiology, and End Results (SEER) Programs of the Biometry Branch of the National Cancer Institute between 1973 and 1976, Bader and coworkers³⁵ identified 183 patients with a diagnosis of melanoma confirmed histopathologically (4 of whom were determined, on review of sections of tissue, to have something other than melanoma and therefore were excluded), leaving 179 patients 20 years of age or younger with melanoma as the corpus of their series. They recorded their findings concerning the incidence and cause of melanoma in an article in 1985 titled, "Childhood malignant melanoma: Incidence and etiology." Included in this series, too, in addition to the 179 patients, were 154 patients studied by Pratt et al. and Boddie et al. Bader and associates concentrated primarily on the incidence of melanoma in children and adolescents, justifying that focus in these words: "Most published reports of melanoma in children and adolescents have emphasized clinical and pathologic findings in small series of patients at single institutions. The 183 patients in this collaborative study provide new data on incidence and distribution of primary sites of childhood melanoma." They neither discussed histopathologic findings nor showed photomicrographs, but they had this to say about age in relation to development of melanomas in children, adolescents, and young adults: