Melanocytes/Melanoma Associations of Statins and Diabetes with Diagnosis of Ulcerated Cutaneous Melanoma

Ulcerated primary melanomas are associated with an inflammatory tumor micro-environment. We hypothesised that systemic pro-inflammatory states and anti-inflammatory medications are also associated with a diagnosis of ulcerated melanoma. In a cross-sectional study of 787 patients with newly-diagnosed clinical stage IB or II melanoma, we estimated odds ratios (ORs) for the association of pro-inflammatory factors (high body mass index (BMI), diabetes, cardiovascular disease, hypertension and smoking) or use of anti-inflammatory medications (statins, aspirin, corticosteroids and non-steroidal anti-inflammatory drugs), with ulcerated primary melanoma using regression models and subgroup analyses to control for melanoma thickness and mitotic rate. Based on information from 194 patients with ulcerated and 593 patients with non-ulcerated primary melanomas, regular statin users had lower likelihood of a diagnosis of ulcerated primary melanoma (OR 0.67, 95% CI 0.45-0.99) and this association remained after adjusting for age, sex, thickness and mitosis. When analysis was limited to melanomas that were ≤2mm thick and had ≤2 mitoses/mm2 (40 ulcerated; 289 without ulceration), patients with diabetes had significantly raised odds of diagnosis of ulcerated melanoma (OR 2.90, 95% CI 1.07-7.90), adjusted for age, sex, BMI and statin use. These findings support our hypotheses that statin use is inversely associated, and diabetes is positively associated, with ulcerated melanoma.