Management and Dermoscopy of Fast-Growing Nevi in Pregnancy: Case Report and Literature Review

Zampetti, Anna; Feliciani, Claudio; Landi, Francesco; Capaldo, M.L.; Rotoli, M; Amerio, Pierluigi

doi:10.2310/7750.2006.00047

Cited by 9 publications

(6 citation statements)

References 16 publications

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“…4 , 6 – 8 Some studies reported cases of melanoma during pregnancy, pigmentation during oral contraceptives (OC) use, and blackening and enlargement of nevi during pregnancy. 9 – 12 These descriptive findings raise the possibility that female sex hormones or reproductive effects may be involved in the etiology of female melanoma.…”

Section: Introductionmentioning

confidence: 99%

<p>Effects of Exogenous Hormones and Reproductive Factors on Female Melanoma: A Meta-Analysis</p>

Sun

Cong

et al. 2020

CLEP

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Epidemiological findings on the effects of hormones on melanoma risk have been inconsistent. We therefore conducted a meta-analysis to examine the relationship between exogenous hormonal and reproductive factors and the risk of melanoma in women. We performed a search of PubMed, Web of Science, and the China National Knowledge Infrastructure (CNKI) database through April 2020 for relevant studies. Based on heterogeneity, we performed the meta-analysis of the risk estimates using either fixed effect or random effect models. We identified 38 studies that met the analytical criteria, involving 3,571,910 participants. The results showed that long-term use of oral contraceptives (OC) may increase the risk of melanoma in women (≥5 years [pooled RR=1.18; 95% CI: 1.07–1.31; I 2 =0%] and ≥10 years [pooled RR=1.25; 95% CI: 1.06–1.48; I 2 =0%]). Women who first used OC 15–19 years previously were more likely to develop melanoma (pooled RR=1.52; 95% CI: 1.03–2.24; I 2 =0%), while the years since the last use and the age at first use were not associated with the development of melanoma in women. Hormone replacement therapy (HRT) increased the incidence of melanoma in women (pooled RR=1.12, 95% CI: 1.02–1.24; I 2 =50%) and was especially associated with an increased risk of superficial spreading melanoma (SSM) (pooled RR=1.26; 95% CI: 1.17–1.37; I 2 =0%), and estrogen and estradiol may be the main active agents that contribute to the increased risk of melanoma, but these results may be due to a combination of sun exposure factors. With regard to reproductive factors, decreased parity and being aged ≥20 years at first birth may be associated with an increased risk of melanoma in females, while menopausal status and age at menarche are not associated with the incidence of melanoma in females. Further large-scale prospective studies are necessary to reveal new pathophysiological mechanisms and new therapeutic targets for cutaneous melanoma.

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Section: Introductionmentioning

confidence: 99%

<p>Effects of Exogenous Hormones and Reproductive Factors on Female Melanoma: A Meta-Analysis</p>

Sun

Cong

et al. 2020

CLEP

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“…Duarte et al reported a new lesion in the nipple of a pregnant woman that involuted to its baseline size 2 months after delivery [8]. Zampetti et al described modifications of a preexisting nevus on the nose [13]. Although we had only 2 patients younger than 30 years, we could observe that pregnant women at this age presented more new lesions than older women.…”

Section: Discussionmentioning

confidence: 67%

“…The use of digital follow-up and dermoscopy to evaluate pigmented lesion changes in pregnancy is certainly the best approach in early detection of melanoma in pregnancy in high-risk patients for melanoma. They are noninvasive tools and do not carry any fetal risk [13,16].…”

Section: Discussionmentioning

confidence: 99%

“…Despite pregnancy effects, we suggest that sun exposure may play a major role in this association. Previous reports described single nevus modifications during pregnancy [8,13,16,17]. Duarte et al reported a new lesion in the nipple of a pregnant woman that involuted to its baseline size 2 months after delivery [8].…”

Section: Discussionmentioning

confidence: 99%

“…Most studies that have been published on dermoscopic changes of nevi during the gestational period have evaluated only a few lesions from each patient [2,7,[8][9][10][11][12][13][14][15]. As far as we know there are no reports of total body photography in pregnant women.…”

Section: Introductionmentioning

confidence: 99%

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Total Body Photography and Sequential Digital Dermoscopy in Pregnant Women

Martins-Costa

Bakos

2019

Dermatol Pract Concept

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Background: Melanocytic nevi can vary in size and number in pregnant women, and the differential diagnosis with melanoma may be challenging. Objectives: To describe changes in total body photography of pregnant women and dermoscopy aspects of their nevi. Methods: A prospective cohort study with 703 melanocytic nevi from 18 women was performed, comparing them in the first and third trimester of pregnancy. Images were analyzed between the 2 periods for changes in dermoscopic aspects. Results: Total body photography images indicated that 44% of patients had new lesions. Regarding the observed changes, there were symmetric or regular changes of the network (23% of cases), occurrence of new globules/dots (12.4%), new vascular structures (3.2%), new streaks (1.7%), and new structureless area (1.0%). Moreover, 55.0% of the nevi increased in size. Enlarging of the nevi was observed mostly on the abdomen (87.1%; P < 0.001) and showed more network changes (27.1%; P = 0.014) and formation of new globules and dots (16.0%; P < 0.001). Patients with a risk of developing melanoma presented more frequently enlarged nevi (45%; P = 0.019). The association between streak formation and skin type was significant (P = 0.012) and was more frequent in skin type II (2.7%), when compared with skin types III (1.3%) and IV (0%).

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Using Dermoscopic Criteria and Patient-Related Factors for the Management of Pigmented Melanocytic Nevi

Zalaudek

Docimo

Argenziano³

2009

Arch Dermatol

101

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Objective: To review recent dermoscopy studies that provide new insights into the evolution of nevi and their patterns of pigmentation as they contribute to the diagnosis of nevi and the management of pigmented melanocytic nevi. Data Sources: Data for this article were identified by searching the English and German literature by Medline and Journals@Ovid search for the period 1950 to January 2009. Study Selection: The following relevant terms were used: dermoscopy, dermatoscopy, epiluminescence microscopy (ELM), surface microscopy, digital dermoscopy, digital dermatoscopy, digital epiluminescence microscopy, digital surface microscopy, melanocytic skin lesion, nevi, and pigmented skin lesions. There were no exclusion criteria. Data Synthesis: The dermoscopic diagnosis of nevi relies on the following 4 criteria (each of which is characterized by 4 variables): (1) color (black, brown, gray, and blue); (2) pattern (globular, reticular, starburst, and homogeneous blue pattern); (3) pigment distribution (multifocal, central, eccentric, and uniform); and (4) special sites (face, acral areas, nail, and mucosa). In addition, the following 6 factors related to the patient might influence the pattern of pigmentation of the individual nevi: age, skin type, history of melanoma, UV exposure, pregnancy, and growth dynamics. Conclusions: The 4×4×6 “rule” may help clinicians remember the basic dermoscopic criteria of nevi and the patient-related factors influencing their patterns. Dermoscopy is a useful technique for diagnosing melanocytic nevi, but the clinician should take additional factors into consideration to optimize the management of cases of pigmented lesions.

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Management and Dermoscopy of Fast-Growing Nevi in Pregnancy: Case Report and Literature Review

Cited by 9 publications

References 16 publications

<p>Effects of Exogenous Hormones and Reproductive Factors on Female Melanoma: A Meta-Analysis</p>

<p>Effects of Exogenous Hormones and Reproductive Factors on Female Melanoma: A Meta-Analysis</p>

Total Body Photography and Sequential Digital Dermoscopy in Pregnant Women

Using Dermoscopic Criteria and Patient-Related Factors for the Management of Pigmented Melanocytic Nevi

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