# Prevention Works Best in Pairs: An Observational Study on Connubial Melanoma

## TL;DR

This study shows that couples share melanoma risk factors, but women are more proactive in seeking early detection for their partners, leading to better outcomes.

## Contribution

The study highlights the role of women in initiating dermatological evaluations for their spouses, influencing earlier melanoma diagnosis.

## Key findings

- Women used tanning devices more frequently and had more sunburns than men.
- Wives initiated dermatological evaluations in 86.5% of cases, leading to earlier melanoma diagnosis for husbands.
- Melanoma localization differed by sex, with women more likely to have lesions on the lower limbs and men on the trunk.

## Abstract

Background: Connubial melanoma, the occurrence of melanoma in non-consanguineous spouses, is rarely described in the literature. This study aimed to evaluate the prevalence of shared risk factors, preventive behaviors, and the influence of couple dynamics on the early diagnosis of cutaneous melanoma (CM). Methods: We conducted a retrospective observational study at the San Gallicano Dermatological Institute IRCCS, Rome, enrolling 52 heterosexual couples diagnosed with CM between 2010 and 2023. Clinical and anamnestic data, including phototype, history of sun exposure, use of tanning devices, and reason for dermatological evaluation, were collected. Dermatological assessments included dermoscopy, total body photography, and histological examination of excised lesions. Statistical analyses were performed using chi-square and Student’s t-tests. Results: Women reported significantly higher use of artificial ultraviolet sources (51.9% vs. 19.2%, p < 0.001) and more frequent histories of sunburn. Phototype II was associated with higher use of tanning devices and a greater prevalence of sunburns. Although the CM stage did not significantly differ between sexes, husbands exhibited a greater Breslow thickness. Melanoma localization differed by sex, with lower limbs more often affected in women and the trunk in men (p < 0.001). In 86.5% of cases, wives initiated their husband’s dermatological evaluation, leading to earlier diagnosis. Conclusions: Despite shared environmental exposures, men and women differ in preventive behaviors and risk profiles. Women play a crucial role in promoting early detection among couples. Couple-based preventive strategies may be instrumental in improving early melanoma diagnosis and outcomes.