Nevi and pregnancy

Physiologic changes of pregnancy: A review of the literature

“…Melanocytes may be more sensitive to the elevated levels of α- and β-melanocyte-stimulating hormone, estrogen, progesterone, and β-endorphins. These hormones likely stimulate the production of melanin, which underlie the hyperpigmentation that is seen clinically ( Bieber et al, 2016 ). Upregulation of tyrosinase by human placental lipids may further potentiate melanin synthesis ( Bieber et al, 2017 , Tyler, 2015 ).…”

“…Historically, melanocytic nevi were thought to darken during pregnancy; however, studies have revealed that this phenomenon is uncommon during pregnancy and requires further research ( Bieber et al, 2016 ). Although color changes are uncommon, nevi are likely to undergo some widening in diameter when they are located in areas that are affected by skin stretching and particularly the chest and abdomen ( Akturk et al, 2007 , Bieber et al, 2016 , Goldberg and Maloney, 2013 ).…”

“…Historically, melanocytic nevi were thought to darken during pregnancy; however, studies have revealed that this phenomenon is uncommon during pregnancy and requires further research ( Bieber et al, 2016 ). Although color changes are uncommon, nevi are likely to undergo some widening in diameter when they are located in areas that are affected by skin stretching and particularly the chest and abdomen ( Akturk et al, 2007 , Bieber et al, 2016 , Goldberg and Maloney, 2013 ). Several reports describe the transient dermoscopic changes in nevi such as new dot formation, thickening of the pigment network, darkening of globules, and increasing numbers of vessels, which are not necessarily suggestive of melanoma ( Akturk et al, 2007 , Bieber et al, 2016 , Goldberg and Maloney, 2013 ).…”

“…These include increased numbers of dermal mitoses and what have been termed “superficial micronodules of pregnancy,” which are rounded clusters of large epithelioid melanocytes with prominent nucleoli, abundant pale eosinophilic cytoplasm, and occasional fine melanosomes. The significance of these remains unclear because they are also found in patients who are not pregnant ( Bieber et al, 2016 , Chan et al, 2010 ). Although physiologic changes of nevi do occur, any changes in their clinical appearance that elicit concern for malignancy warrant an immediate biopsy, which can be performed safely with the use of lidocaine regardless of the location or trimester of pregnancy ( Goldberg and Maloney, 2013 ).…”

Pregnancy and Melanoma: Recommendations for Clinical Scenarios

“…It is important to keep in mind that during pregnancy, nevi on the breasts and abdomen commonly grow with normal skin expansion. Sometimes corresponding transient dermoscopic changes in melanocytic nevi on expanding skin can be seen, however, these changes do not necessarily imply malignancy ( Bieber et al, 2016 ). Patients with atypical nevi may undergo more changes in their moles during pregnancy ( Ellis, 1991 ), though recent evidence suggests that normal nevi should not experience significant change, including darkening ( Bieber et al, 2016 ).…”