Interventional Three-year Longitudinal Study of Melanocytic Naevus Development in Pre-school Children in Dresden, Saxony

Abstract

Acquired melanocytic naevi (MN) are considered a risk factor for melanoma. Exposure to ultraviolet light (UV) is the major environmental factor for MN. UV protection is most critical in pre-school children. This 3-year interventional longitudinal study examined 395 3-year-old children attending daycare centres (DCC) in Dresden, Germany. Photo-skin type, eye and hair colour were recorded. DCC were randomly assigned to a control group and a behavioural intervention group. All children had a regular naevus check-up, including digital objective analysis with Dell'Eva-Burroni Dermoscopy Melanoma Image Processing Software (DB-MIPS) technology. Parents of children in the intervention group received additional guidance for sun-protection. The mean total MN counts of both groups at the start of the study period were 7.19 ± 4.55 (intervention) and 6.84 ± 4.63 (control), respectively. There was a significant increase in MN counts for both groups (mean 12.5 and 13.8). Subgroup analysis for skin type, eye colour, and hair colour did not demonstrate a significant influence on MN counts. The DB-MIPS integrated classifier revealed no risky lesions while analysing their patterns. Intervention did not reduce the number of newly acquired MN. MN counts in pre-school children were approximately 5 times higher than expected from previous large studies in Germany. This is the first study in pre-school children using objective digital image analysis of pigmented lesions. No atypical lesions were observed. New approaches to UV protection in pre-school children are now required.

Pigmented naevi and sun protection behaviour among primary and secondary school students in an Eastern Hungarian city

“…Observations in these studies support the need for consistent counselling with children and their parents regarding the appropriate use of sun protection, which is also confirmed by other studies . Moreover, environmental interventions, such as the use of shade structures, are also required to support educational lessons , besides combined behavioural and political interventions .…”

Optimal management of common acquired melanocytic nevi (moles): current perspectives

“…Recent studies have suggested that significant increases in melanocytic nevi counts in preschool children call for improved ultraviolet protection, but knowledge does not automatically change behavior. 65 The use of any management decision in children with familial melanoma should be tempered by the findings of a recent study, where atypical nevi in childhood, the nevus count of atypical nevi on the buttocks, and most importantly, the number of excisions during follow-up correlated with the risk of melanoma. 66 In Caucasian skin, it is believed that the total number of CAMN on the whole body is the most important independent risk factor for melanoma, and the risk of melanoma development increases almost linearly with rising numbers of melanocytic nevi.…”

Melanoma Epidemiology and Prevention

“…In childcare settings, two studies reported no change in sun exposure measured by parent reports or by change in melanocytic nevi in the children's skin [18,19,246], but one study did find that children spent less time outdoors during peak sun hours at childcare centers with sun protection policies [124]. One study also failed to produce changes in sunburn prevalence after an educational intervention with parents [18,19].…”