Natural history of dysplastic nevi

Halpern, Allan C.; Guerry, D.; Elder, David E.; Trock, Bruce J.; Synnestvedt, Marie; Humphreys, Tatyana R.

doi:10.1016/0190-9622(93)70151-i

Cited by 109 publications

(95 citation statements)

References 15 publications

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“…[12][13][14][15][16][17] Thus, the majority of melanomas do not arise in association with a demonstrable nevus. The prevalence of dysplastic nevi is vastly greater in populations than that of melanoma, indicating, consistent with clinical observations, 18 that most dysplastic nevi are stable and do not progress to melanoma. Thus, there is no justification for the wholesale excision of dysplastic nevi in an effort to prevent melanoma.…”

Section: Dysplastic Nevisupporting

confidence: 65%

“…The lesion is broader than 5 mm, within a regular border that is indefinite or 'fuzzy' in some areas, and with slightly variegated shades of tan and brown pigment. 18 presented data from a cohort study in a pigmented lesion clinic to indicate that the risk for melanoma may be increased more than a 1000-fold in individuals who have the combination of dysplastic nevi on their skin with a family and personal history of melanoma. Mackie et al 32 presented a 'risk factor chart' for a Scottish population, which demonstrates the interactions among several risk factors (total number of benign pigmented nevi above 2 mm diameter, freckling tendency, number of clinically atypical nevi, and a history of severe sunburn at any time in life) quite well.…”

Section: Dysplastic Nevimentioning

confidence: 99%

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Precursors to melanoma and their mimics: nevi of special sites

2006

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Melanocytic nevi, which are benign tumors of melanocytes, may have occasional cosmetic significance but, for the most part, they are important only in relation to melanoma. Nevi are the most important simulants of melanoma, both clinically and histologically, and can usually be reliably distinguished from melanomas using published criteria. Some lesions are characterized by greater degrees of atypia and may be more difficult to diagnose. Dysplastic nevi are among the most important simulants of melanoma. Nevi may also be important as potential precursors of melanoma; however, most nevi are stable and will not progress to malignancy. Nevi are vastly more common than melanomas and the rate of progression of individual lesions is very low. Therefore, nevi are not as a rule managed by wholesale excision to prevent melanoma. Nevi are also important as risk markers, identifying individuals at greater risk of developing melanoma in the future. Dysplastic nevi and, to a lesser extent, common acquired and congenital nevi are among the most important melanoma risk markers. Nevi of special sites have been identified as nevi that may show atypical features suggestive of a dysplastic nevus or of a melanoma. However, they are not risk markers and they are not malignancies. Nevi of genital skin, acral skin, and flexural skin are among the most important 'nevi of special sites'. It is important, in considering the differential diagnosis of a lesion in a special site, to avoid overcalling such a lesion as a melanoma or a dysplastic nevus because this could lead to excessive treatment. Conversely, it is important to avoid undercalling a lesion that is a dysplastic nevus or a melanoma as a nevus of special sites, because in this circumstance a patient could lose the opportunity either for surveillance to recognize a developing melanoma at an early, curable stage, or for definitive treatment of an established malignancy. In this monograph, dysplastic nevi and nevi of special sites are compared and contrasted in relation to melanoma.

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Section: Dysplastic Nevisupporting

confidence: 65%

Section: Dysplastic Nevimentioning

confidence: 99%

Precursors to melanoma and their mimics: nevi of special sites

2006

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“…The natural history of dysplastic nevi and melanoma does not appear different in families with identified CDKN2A mutations, CDK4 mutations, or no identified mutations in CDKN2A or CDK4 . In both melanoma-prone family members and in unselected individuals with dysplastic nevi (Halpern et al, 1993a), the majority of lesions are stable over time or regress. The Melanoma Genetics Consortium is currently collecting consistent phenotype data across multiple groups to evaluate dysplastic nevi as a modifier of risk of melanoma associated with mutations in melanoma susceptibility genes.…”

Section: Number and Type Of Nevimentioning

confidence: 99%

Melanoma etiology: where are we?

Tucker¹,

Goldstein²

2003

Oncogene

241

147

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Melanoma incidence rates are rising rapidly, particularly in older men. Older men are also more likely to have thick melanomas, which confer high mortality and morbidity. The reasons for the rate of increase are not known; increasing sun and UV exposure, however, is the major hypothesized explanation. In the past several years, two major susceptibility genes for melanoma, CDKN2A and CDK4, have been identified, but the two genes together account for a minority of familial melanoma. Other highrisk susceptibility genes are being sought actively. Genetic epidemiologic studies suggest that penetrance of each of the two identified genes is altered by other factors, either genetic or environmental. Epidemiologic studies have also identified other major host factors important in the development of melanoma. In European, North American, and Australian populations, the presence of clinically identified dysplastic nevi confers greatly increased risk of melanoma. A new measure of sun exposure, based on individual residential history, confers substantially increased risk of melanoma. Recent surveys of sun behavior in the US reveal extensive sunburning and use of tanning beds in adolescents and adults. Sun protective behaviors are not as prevalent as in Australia, where population rates of melanoma are stabilizing.

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“…Two previous studies support the observation that nevi become more stable in patients with increasing age. Halpern et al 20 reported that 33% of patients had new dysplastic nevi appear on their backs during a mean follow-up of 89 months, with the highest rate occurring in patients younger than 30 years (76%), which then decreased with increasing age. Histologically, Lund and Stobbe 22 demonstrated that with increasing age, nevi become less active and more mature so that fewer changes and less regression occur.…”

Section: Commentmentioning

confidence: 99%

“…[19][20][21][22][23] In these high-risk patients, increased rates of melanoma were found in all age groups. Patients younger than 50 years, and especially those younger than 30 years, had more new, changed, and regressed nevi and fewer melanomas detected.…”

Section: Commentmentioning

confidence: 99%