Eruptive Cherry Angiomas and Skin Melanoma: Further Insights into an Intriguing Association

Abstract

<b><i>Background:</i></b> Some risk factors for malignant melanoma (MM) are recognized. <b><i>Objective:</i></b> To compare the strength of association between MM and eruptive cherry angiomas (CAs) with that of other well-known associations. <b><i>Methods:</i></b> This cross-sectional study included all subjects referred to the Outpatient Dermatology-Oncology and Dermoscopy Units of the Universities of Ferrara and Bologna, Italy, over a 5-month period and submitted to total body skin examination. We recorded: age, sex, cutaneous and non-cutaneous malignancies, presence of CAs, arbitrarily considered as “eruptive” when >10, >40 common melanocytic naevi or >2 clinically atypical naevi. The strength of association between the possible risk factors and MM was calculated by odds ratio in both the whole population and age quartiles. Variables associated with MM were included in multiple logistic regression analysis. <b><i>Results:</i></b> 1,190 subjects were included; 615 had malignant skin tumours, 462 MM, 85 extracutaneous tumours. Five hundred and eighty-seven subjects had eruptive CAs, 485 subjects >40 melanocytic naevi and 368 more than 2 atypical melanocytic naevi. Eruptive CAs, especially in subjects younger than 70, and >2 atypical melanocytic naevi, mostly in subjects older than 50, were significantly associated with MM. The strength of these 2 associations was similar. The presence of >40 melanocytic naevi was not associated with MM. <b><i>Conclusions:</i></b> These findings confirmed an association between MM and eruptive CAs, which was as strong as the one between MM and >2 atypical melanocytic naevi. CAs seem an intriguing model of interaction between heterogeneous variables, like immunocompetence, stimuli inducing endothelial cell proliferation, and oncogenesis, which deserves further investigation.

Eruptive cherry angiomas and uveal melanoma: beyond a simple association

“…The aetiology of eCAs has not been fully elucidated but chemicals, immunosuppression, chronic graft‐versus‐host disease, lymphoproliferative diseases, human herpesvirus‐8 infection and downregulation of microRNA‐424 have been considered as potential inducers or predisposing factors for the development of CAs 2 . We found that more than half of our patients with UM had eCA, which is higher than the global population prevalence (range 41%–48%) 4 …”

“…The onset of eCAs is typically 40–50 years of age and they tend to increase in number and size with time, 2 which could explain the relatively high incidence of eCAs in our UM sample. Patients with UM and eCAs were slightly younger than patients with UM without eCAs; this association might be spurious, or it might suggest a potential association between the two lesions.…”

“…In previous studies, a clinical association between eruptive cherry angiomas (eCAs) and cutaneous malignancies has been found 1,2 2 .…”

“…In previous studies, a clinical association between eruptive cherry angiomas (eCAs) and cutaneous malignancies has been found 1,2 2 . While the association of eCAs with cutaneous melanoma has been well established, the rate of association with other rare melanocytic malignancies, such as uveal melanoma (UM) has not been yet explored.…”

“…Patients with UM were included in the analysis, and personal and family history was acquired. Based on previously published studies, CAs were arbitrarily considered as eruptive when > 10 in number; similarly, the total number of naevi (TNN) was dichotomized into TNN > 10 and ≤ 10 2,3 …”