Twenty nevi on the arms

Abstract

Patients with a high total nevus count (TNC) merit a total-body examination, but a simple strategy to identify these high-risk individuals is essentially missing. The aim of this study was to investigate the correlation between the number of melanocytic nevi on both arms and the TNC, and to evaluate patient variables that may have an effect on this association. In this multicenter, cross-sectional study, 2175 patients were examined and the mean number of arm nevi in relation to TNC was calculated. A mean value of fewer than 10 arm nevi was found in patients with TNC lower than 51 and a mean value of greater than 19 arm nevi was scored in patients with TNC greater than 50. These values remained unchanged after adjustment for various patient variables. In relation to TNC greater than 50, the presence of 20 or more arm nevi had specificity and negative predictive values of 95.2 and 89.6%, respectively. The sensitivity was 65.5% in patients younger than 50 years of age and 37.5% in the older age group. The number of arm nevi was significantly higher in individuals with a history of melanoma and in those with a melanoma detected during the study period. The presence of 20 or more nevi on the arms is an independent predictor of a high TNC and risk of melanoma. This sign thus represents a simple and rapid screening tool for either the primary care physician or the dermatologist to help identify high-risk patients.

Role of community pharmacists in skin cancer screening: A descriptive study of skin cancer risk factors prevalence and photoprotection habits in Barcelona, Catalonia, Spain

“…Our data has similar values to those observed in other studies performed in Southern Spain, when it comes to skin cancer family and personal history 64. Furthermore, melanocytic nevi count proportion differs substantially from other studies, with 43.8% of participants with more than 10 nevi on one arm in our case 19,20,36,64. This nevi over count could be due to different facts: the average age in our study is 56 years old, and only 31.5% of the participants are younger than 50 years old; while nevi counting of more than 20 nevi in both arms as a skin risk factor tool has only been proved useful in people younger than 50 years old 19,36.…”

“…Our project has set the basis for an ongoing collaborative practice agreement for skin cancer screening, between pharmacists from Col·legi de Farmacèutics de Barcelona, the only professional registration body for pharmacists in Barcelona, and dermatologists from Hospital Clínic de Barcelona, one of the most important tertiary hospitals in Spain. In our program, diagnostic is exclusively reserved to TBSE by GP or dermatologists, and pharmacists’ role is genuinely triaging based in well-described skin cancer risk factors 18,19,50,51. The prevalence of these skin cancer risk factors in Barcelona community pharmacy users is described here for the very first time.…”

“…The questionnaire collected information on demographic characteristics, photoprotection behaviours and skin cancer risk factors. Data on the five most important skin cancer risk factors in Southern and Central European population were registered: family and personal history of skin cancer, nevi arm count in one arm skin exploration was used as a skin cancer predictor to simplify triage by skin examination and nevi count, presence of sun-damaged skin and self-reported presence of melanoma-like suspicious lesions 18,19,36. A linguistic copyeditor evaluated the clarity of the questionnaire and its comprehension was validated by 11 laypeople ranging from 18 to 84 years old not related to healthcare professions.…”

“…In southwestern Europe the most important risk factors are a high count of nevi all over the body, having dysplastic nevi, familial history of melanoma, personal history of skin cancer and being of fairer Fitzpatrick phototypes 18. Some authors propose that arm nevi count could be a proxy assessment of whole body nevi count 19…”

Skin Cancer: Epidemiology, Disease Burden, Pathophysiology, Diagnosis, and Therapeutic Approaches

“…Clinicians should ideally perform total body skin examination (see Fig. 4 as an example case of actinic keratosis appearing on the back of the hand, as is often overlooked), at least for high-risk individuals [ 31 , 32 ]. The use of non-invasive optical technologies, such as optical coherence tomography (non-invasive imaging test of the retina using light waves) or dermatoscopy (imaging of the skin, allowing statements concerning thickening of layers, epidermal organization, and borders of a lesion—in the case of actinic keratosis, the typical honeycomb pattern may be observed), may be helpful to improve diagnostic accuracy in some skin cancers [ 33 – 37 ] (the case presented in Fig.…”