The number and distribution of benign pigmented moles (melanocytic naevi) in a healthy British population

Mackie, RonaM.; English, John; Aitchison, Tom; Fitzsimons, Clare P.; Wilson, P.D.

doi:10.1111/j.1365-2133.1985.tb02060.x

Cited by 224 publications

(136 citation statements)

References 8 publications

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“…While two previous studies have touched on the subject of inter-observer agreement on clinical diagnosis of nevi (MacKie et al, 1985;Cooke, 1988) (Cooke, 1988). The three observers reviewed 200 clinical photographs of flat, tan nevi 2 to 4 mm in diameter and concurred on a diagnosis of melanocytic nevus in 89% of the lesions.…”

Section: Discussionmentioning

confidence: 99%

Inter-clinician agreement on the recognition of clinical pigmentary characteristics of patients with cutaneous malignant melanoma. Studies of melanocytic nevi, VI

Roush

Barnhill²,

Ernstoff³

et al. 1991

Br J Cancer

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Summary The number and type of melanocytic nevi are among the most important known predictors of risk for cutaneous malignant melanoma. In this study, examinations of the skin were conducted by two to four clinicians on 153 patients with newly diagnosed melanoma, and the agreement among clinicians was quantified regarding number of nevi and freckling. The index of agreement (calculated as the intra-class correlation coefficient) was 59.7% and 69.0% for freckling on the right forearm and on the shoulders, respectively; agreement was above 50% for only one of six pairs of clinicians in examining freckling on the right forearm, while agreement was above 50% for four of the six pairs of clinicians in examination of freckling on the shoulder. For Materials and methodsOne hundred and fifty-three newly-diagnosed melanoma patients participated in the study and were examined in the Yale Melanoma Unit from 1 January 1983 to 1 July 1987. Participants were selected from incident cases of malignant melanoma referred to the Yale Melanoma Clinic for evaluation and treatment primarily from the southern Connecticut region. Criteria for enrollment in the study included newlydiagnosed malignant melanoma, non-Hispanic caucasian subjects, age limitation: above 20 and under 70 years of age.Patients with these criteria were invited to enroll in the study and informed consent was obtained. The proportion of eligible patients who actually participated exceeded two-thirds.Received 27 November 1990; and in revised form 22 March 1991.All study subjects underwent an exam of the entire skin, excluding the genitalia and including an assessment of freckling characteristics; a count of palpable arm nevi below the level of the axillae (nevi could be of any size); a count of any nevi on the arms, palpable or not; a count of total body nevi 3 mm or greater in longest diameter, a count of the total number of atypical nevi, and an in-depth assessment of the atypical nevi . Freckles were defined as light-tan to brown, completely macular lesions, without any surface change or distortion of skin cleavage lines, and generally measuring from 2-3 mm to 10 mm in diameter. Melanocytic nevi were defined as relatively flat (but associated with accentuation of skin cleavage lines) or raised lesions, generally measuring greater than 3 to 5 mm in diameter, and pink, flesh-coloured, or pigmented. Distinction of a junctional nevus from a simple lentigo is difficult. In our experience, most lentigines are macular, do not exhibit distortion of skin cleavage lines, and measure 2-3 mm in diameter (but may be larger). Junctional nevi, on the other hand, are frequently slightly palpable, exhibit distortion of skin cleavage lines, and usually measure greater than 3 mm in size. A small proportion of lesions can only be distinguished by histological examination. Nevi were further defined as not being obvious seborrheic keratoses, solar lentigines, warts or dermatofibromas. The designation of a nevus as atypical was based on the subjective assessment of each individual ...

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Section: Discussionmentioning

confidence: 99%

Inter-clinician agreement on the recognition of clinical pigmentary characteristics of patients with cutaneous malignant melanoma. Studies of melanocytic nevi, VI

Roush

Barnhill²,

Ernstoff³

et al. 1991

Br J Cancer

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“…Although some older reports suggested that they should be removed to prevent malignant change, acral nevi are present in as many as 4-9% of the population, 60 and melanomas are very rare in these sites. Histologically, acral nevi tend to be more cellular than most common nevi, and the nevus cells may be arranged in predominantly lentiginous rather than nested patterns in the epidermis.…”

Section: Nevi Of Acral Skinmentioning

confidence: 99%

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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“…In adults, there have been no formal studies looking at the difference in naevus phenotype in countries with different exposure patterns. Based on naevus count studies, there is no evidence of a relationship between mean numbers of naevi per individual and melanoma incidence in different countries: naevus-counting studies in healthy individuals in Australia (Nicholls, 1973), New Zealand (Cooke et al, 1985) and the USA have not shown major differences in mean naevus count from those carried out in the UK (MacKie et al, 1985) and Switzerland (Sigg and Peloni 1989). However, these studies have involved different examiners and different naevus-counting protocols, and the results are difficult to compare.…”

mentioning

confidence: 99%

The association between naevi and melanoma in populations with different levels of sun exposure: a joint case-control study of melanoma in the UK and Australia

Bataille¹,

Grulich²,

Sasieni³

et al. 1998

Br J Cancer

101

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Summary Two case-control studies were set up to investigate the relationship between melanocytic naevi and risk of melanoma and to compare the naevus phenotype in two countries exposed to greatly different levels of sun exposure and different melanoma rates. In England 117 melanoma cases and 163 controls were recruited from the North-East Thames Region and 183 melanoma cases and 162 controls from New South Wales, Australia. Each subject underwent a whole-body naevus count performed by the same examiner in each country. Relative risks associated with melanocytic naevi in each country were calculated with comparison of naevus data in controls between Australia and England. Atypical naevi were strong risk factors for melanoma in both countries: the odds ratio (OR) for three or more atypical naevi was 4.6 (95% Cl 2.0-10.7) in Australia compared with 51.7 (95% Cl 6.5-408.4) in England. Common naevi were also significant risk factors in Australia and England with similar odds ratios in the two countries. Prevalence of atypical naevi was greater in Australian controls than in English controls: OR 9.7 (95% Cl 1.2-81.7) for three or more atypical naevi in Australia compared with England. For young age groups, the median number of common naevi was greater in Australia than in the UK, whereas for older individuals this difference in naevi number between the two countries disappeared. The prevalence of naevi on non-sun-exposed sites in controls was not significantly different between the two countries. The atypical mole syndrome (AMS) phenotype was more prevalent in Australian controls (6%) than in English controls (2%). The results of this study support the role of sun exposure in the induction of atypical naevi in adults. There was a trend towards stronger risk factors associated with atypical naevi in England compared with Australia. The atypical mole syndrome, usually associated with a genetic susceptibility to melanoma, was more common in Australia than in England, suggesting genetic environmental interactions with the possibility of phenocopies induced by sunlight.

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The number and distribution of benign pigmented moles (melanocytic naevi) in a healthy British population

Cited by 224 publications

References 8 publications

Inter-clinician agreement on the recognition of clinical pigmentary characteristics of patients with cutaneous malignant melanoma. Studies of melanocytic nevi, VI

Inter-clinician agreement on the recognition of clinical pigmentary characteristics of patients with cutaneous malignant melanoma. Studies of melanocytic nevi, VI

Precursors to melanoma and their mimics: nevi of special sites

The association between naevi and melanoma in populations with different levels of sun exposure: a joint case-control study of melanoma in the UK and Australia

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