Large congenital melanocytic nevi and the risk for the development of malignant melanoma. A prospective study

Marghoob, Ashfaq A.

doi:10.1001/archderm.132.2.170

Cited by 90 publications

(96 citation statements)

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“…Physicians agree that an increased risk for the development of MM is associated with large CMN [25,26,27,28,29,30,31,32,33,34,35,36], the risk association with small and medium-sized CMN remaining controversial [1,37,38,39,40,41,42]. The incidence of MM arising in the context of large CMN ranges from 0.3 to 12.4% in different studies (table 1).…”

Section: Discussionmentioning

confidence: 99%

Congenital Melanocytic Nevus: An Epidemiologic Study in Italy

Ingordo¹,

Gentile²,

Iannazzone³

et al. 2007

Dermatology

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Background: The prevalence of congenital melanocytic nevi (CMN) among newborns ranges between 0.2 and 6% in the worldwide literature. In the only available study from Italy the rate was 1% at birth and 1.4% at 2 years of age. Some surveys performed among samples of children and adolescents in other countries showed a prevalence which ranged from 1.4 to 4.4%. Additional data on the frequency in adults are not available. Objective: The aim of this study was to estimate the prevalence of CMN in a large sample of a young male Italian population, which is deemed to be representative of the general population of the same age and sex. Methods: The potential conscripts resident in the coastal regions of southern Italy, enlisted for the compulsory service in the Italian Navy, were called at the age of 18 to the Draft’s Council Medical Unit of the Italian Navy in Taranto to evaluate their psychophysical fitness to recruitment. All the subjects examined from September 2002 to March 2004 showing skin lesions evocative of CMN were referred by general practitioners of the Draft’s Council Medical Unit to the Department of Dermatology of the Italian Navy Hospital for confirming the diagnosis, which was based on the clinical features and the personal history. The confirmed cases were recorded in a predefined patient card, containing the main anamnestic and clinical data. Since the screening of small CMN in such a large sample of subjects was believed to be difficult, only CMN with a diameter ≧1.5 cm were recorded. Results: In 23,354 examined persons 157 CMN were diagnosed, with a prevalence of 0.67% (Bayesian 95% confidence interval 0.57–0.79); 126 (80.3%) CMN were medium-sized (≧1.5 and ≤19.9 cm in diameter), and 31 (19.7%) were large (≧20 cm in diameter). Three CMN (1.9%) were located on the face, 23 (14.6%) on the chest, 24 (15.2%) on the abdomen, 36 (22.9%) on the back, 48 (30.5%) on the lumbar area, 15 (9.5%) on the upper limb, 19 (12.1%) on the lower limb and 15 (9.5%) on the shoulder. No CMN was located on the head. In 19 cases (12.1%) ≧2 adjacent anatomical sites (shoulder/chest, shoulder/arm, etc.) were involved. In 73 moles (46.4%) terminal hairs were present. Eight CMN (5.1%) showed a zosteriform (i.e. segmental) feature. None of the examined subjects reported a personal history of malignant melanoma (MM), and no person with a history of MM was observed among all the enlisted men referred to the Department of Dermatology during the time of the study. Conclusion: The prevalence of CMN in the Italian young male general population is roughly in agreement with the rates detected in general populations from other European studies. The observations of this study also suggest that the risk of appearance of MM, at least in childhood and adolescence, is limited for medium-sized CMN.

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Section: Discussionmentioning

confidence: 99%

Congenital Melanocytic Nevus: An Epidemiologic Study in Italy

Ingordo¹,

Gentile²,

Iannazzone³

et al. 2007

Dermatology

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“…They are commonly classified as small (<1.5 cm), medium-sized (1.5–19.9 cm) and large or giant (20 cm or greater) [6]. Giant CMN has been associated with malignant melanoma [7,8,9,10], whereas the risk related to small and medium-sized CMN is still controversial [11,12,13,14]. CMN may exhibit distinctive histopathological features that help in distinguishing them from acquired melanocytic nevi, but these histopathological characteristics are not entirely pathognomonic for the diagnosis of CMN [15].…”

Section: Introductionmentioning

confidence: 99%

Dermoscopic Features of Congenital Melanocytic Nevus and Becker Nevus in an Adult Male Population: An Analysis with a 10-Fold Magnification

et al. 2006

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Background: Dermoscopic features of congenital melanocytic nevi (CMN) have been mostly assessed by high-resolution videodermoscopy. However, optical dermoscopy with the 10-fold magnification is largely available. In some instances, the differential diagnosis between large CMN and Becker nevus (BN) may be difficult. Objective: The aims of this work were: (1) to assess by dermoscopy with the 10-fold magnification the morphological features which have been previously suggested as useful for the identification of CMN in high-resolution videodermoscopy; (2) to search and point out the dermoscopic features of BN; (3) to explore dermoscopic differences between CMN and BN. Methods: The subjects were observed among about 23,000 consecutive young men assessed at the Draft Council’s Medical Unit of the Italian Navy in Taranto for compulsory recruitment and referred to the Department of Dermatology of the Italian Navy Hospital for dermatological examination. Lesions were examined by the same observer using a dermatoscope with a 10-fold magnification, and both the dermoscopic criteria stated by the international Consensus Net Meeting on Dermoscopy and dermoscopic features previously suggested as useful for the identification of CMN by videodermoscopy were recorded in a predisposed patient’s card. Results: There were 127 male subjects, median age 19 years, with 127 CMN, measuring ≧1.5 to ≤19.9 cm in 78% and ≧20 cm in 22% of cases, and 64 male subjects, median age 19 years, with 64 BN. In the sample of medium-sized and large CMN, dermoscopic features previously identified as characteristic of congenital lesions (i.e. target network, focal thickening of network lines, target globules, skin furrow hypopigmentation, focal hypopigmentation, hair follicles, perifollicular hypopigmentation, vessels and target vessels) were observed in sufficiently high rates. In the BN group, network, focal hypopigmentation, skin furrow hypopigmentation, hair follicles, perifollicular hypopigmentation and vessels were the main dermoscopic features. Focal thickening of network lines, globules, target globules, homogeneous diffuse pigmentation, hyperpigmented areas, blotches and target vessels were more frequently observed in CMN than in BN. Conclusions: (1) The same dermoscopic features observed in small and medium-sized CMN by videodermoscopy with high magnifications are also detectable in medium-sized and large CMN, employing the dermoscopy with the 10-fold magnification. (2) Network, focal, skin furrow and perifollicular hypopigmentation, hair follicles and vessels could be considered as peculiar dermoscopic features of BN. (3) Major differences in the frequency of dermoscopic characteristics were detected between CMN and BN, and dermoscopy seems to provide some diagnostic aid in differentiating CMN from BN in equivocal cases.

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“…CMN have the tendency to enlarge in proportion to the growth of the child and may additionally develop changes in color and surface topography over time [13,14]. Although the absolute risk for developing melanoma in association with CMN is low, the relative risk is high, and is more significant for larger CMN than for smaller CMN [15]. Thus, it is important to scrutinize these lesions for focal changes that may herald the development of melanoma.…”

Section: Congenital Melanocytic Nevimentioning

confidence: 99%

“…Nearly 75% of patients with large CMN have satellite nevi; however, these satellite nevi do not appear to carry an increased risk for developing cutaneous melanoma [17]. Dermoscopic assessment of the subsurface morphology of CMN and associated satellite lesions with attention to recognizable benign patterns is beneficial in distinguishing CMN from melanoma, and in identifying a focus of melanoma arising along the dermo-epidermal junction within a CMN [15,17]. Most CMN, especially smaller lesions, manifest a symmetric, organized pattern on clinical and dermoscopic evaluation.…”

Section: Congenital Melanocytic Nevimentioning

confidence: 99%