Hintergrund Und Ziele: Eine asymmetrische Verteilung von Melanomen zugunsten der linken Körperhälfte wurde wiederholt beschrieben.
Patienten Und Methodik: In einer prospektiven Querschnittstudie untersuchten wir bei 702 Patienten einer dermatologischen Klinik die Verteilung melanozytärer Nävi zwischen der linken und der rechten Körperhälfte. Außerdem bestimmten wir retrospektiv das Verhältnis von links zu rechts (L/R) von primären Melanomen, Lymphknotenmetastasen und Nävi in Sentinel-Lymphknoten (SN) bei 2004 konsekutiven Melanomfällen.
Ergebnisse: Die L/R-Ratios für kutane Nävi und Melanome betrugen 1,23 (95 %-Konfidenzintervall [KI] 1,12-1,36) sowie 1,6 (95 %-KI 1,37-1,88). Sowohl bei kutanen Nävi als auch bei Melanomen wurde der Linksüberschuss hauptsächlich in intermittierend lichtexponierter Haut gefunden. In der Nävuspopulation waren 92,4 % Rechtshänder. Die Tumordicke nach Breslow und die Ulzerationsrate waren bei linksseitigen oder rechtsseitigen primären Melanomen ähnlich.
Schlussfolgerungen: Melanozytäre Nävi und Melanome sind numerisch häufiger auf der linken Körperhälfte zu finden. Wir nehmen asymmetrische Sonneneinstrahlung als ursächlich an. Die große Mehrheit der Rechtshänder könnte ihre Körperhaltung bei Aktivitäten im Freien unbewusst so ausrichteten, dass das Licht von links einfällt. Dadurch wird der Schattenwurf durch den dominanten Arm, die Schulter oder den Kopf vermieden.
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