The global incidence of cutaneous melanoma (CM) is rising, necessitating early detection and identification of risk factors across different populations. A case–control study with 180 patients with primary diagnosed CM and 182 healthy controls was conducted. Participants underwent ophthalmic and skin examinations, where the identification and counting of common melanocytic nevi (CMN) and atypical melanocytic nevi (AMN) was performed. During ophthalmic examination, high-resolution slit lamp iris images were taken. Images were categorized according to iris periphery, collaret, and freckles. There was no difference in iris periphery and collaret color between groups. However, blue/grey iris periphery and blue collaret with or without freckles were the most common patterns. The presence of pigmented iris lesions and 2–5 mm and ≥5 mm in diameter CMNs was strongly associated with CM risk. The evidence from this study indicates that blue or grey periphery and blue collaret iris pattern with iris freckles are 2.74 times higher in the CM group than controls. Further research is needed to explore iris patterns’ association with CM risk in diverse populations.

Background and Objectives: To our knowledge, this is the first case–control study conducted in the Baltic countries that identified CM risk factors focusing on the investigated subjects’ phenotypic traits, severe sunburns, sunscreen and tanning bed use. Materials and Methods: This study analyses 180 subjects with CM (case group) and 182 randomly selected controls. All participants completed surveys about sun exposure habits and skin phototype (I–IV) according to the Fitzpatrick scale. Skin, eye, and hair colour, number of freckles, and melanocytic nevi greater than 2 mm in diameter (MN > 2 mm) on sites with maximal, intermittent, and minimal sun exposure were examined. Results: We determined five risk factors that significantly increased the odds ratio of CM (OR; 95% confidence interval): tanning bed use compared to non-use (6.46; 1.89–22.96), lack of sunscreen use compared to regular use (7.41; 2.88–19.09), and fair skin compared to medium and olive skin (2.06; 1.03–4.09). The probability of CM also increased with each instance of severe sunburn (2.57; 1.96–3.38) and with each additional MN > 2 mm in sun-exposed areas (1.05; 1.03–1.07). Conclusions: The results of this case–control study offer novel insights into modifiable risk factors for CM, highlighting potential targets for primary prevention strategies in the Baltic countries’ population, with dominant fair phenotypic traits of skin, eye, and hair colour.