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Drug consumption and melanocytic nevi: correlation between oral contraceptives or hormone replacement therapy and a high melanocytic nevi count. Eur J Cancer Prev 2019; 29:338-341. [PMID: 31567537 DOI: 10.1097/cej.0000000000000545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The prolonged use of drugs such as beta-blockers, acetylsalicylic acid, omeprazole, statins, oral contraceptives and hormone replacement therapy might have some role in melanocytic nevi development and be ultimately linked to melanoma risk. Aims of the study were to evaluate a possible association between the above-mentioned drugs and features such as number and atypia of melanocytic nevi in long-term users. We retrospectively looked at pharmacological, clinical and dermoscopic records of 1321 patients that attended our unit for routine mole check between January 2013 and January 2018. Patients were divided into two groups (low or high melanocytic nevi count), and multivariate analysis was performed with regards to the presence and number of melanocytic nevi and drug assumption. A positive association between the use of oral contraceptives or hormone replacement therapy (P = 0.012) and a high melanocytic nevi count was found through multivariate analysis, after adjusting for sex, age and multiple confounding factors, such as freckles, phototype and a reported history of sun exposure and sunburns. Further prospective studies are necessary to establish whether women using oral contraceptives or on hormone replacement therapy should undergo periodic monitoring of pigmented lesions.
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Martins-Costa GM, Bakos R. Total Body Photography and Sequential Digital Dermoscopy in Pregnant Women. Dermatol Pract Concept 2019; 9:126-131. [PMID: 31106015 DOI: 10.5826/dpc.0902a08] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2019] [Indexed: 10/31/2022] Open
Abstract
Background Melanocytic nevi can vary in size and number in pregnant women, and the differential diagnosis with melanoma may be challenging. Objectives To describe changes in total body photography of pregnant women and dermoscopy aspects of their nevi. Methods A prospective cohort study with 703 melanocytic nevi from 18 women was performed, comparing them in the first and third trimester of pregnancy. Images were analyzed between the 2 periods for changes in dermoscopic aspects. Results Total body photography images indicated that 44% of patients had new lesions. Regarding the observed changes, there were symmetric or regular changes of the network (23% of cases), occurrence of new globules/dots (12.4%), new vascular structures (3.2%), new streaks (1.7%), and new structureless area (1.0%). Moreover, 55.0% of the nevi increased in size. Enlarging of the nevi was observed mostly on the abdomen (87.1%; P < 0.001) and showed more network changes (27.1%; P = 0.014) and formation of new globules and dots (16.0%; P < 0.001). Patients with a risk of developing melanoma presented more frequently enlarged nevi (45%; P = 0.019). The association between streak formation and skin type was significant (P = 0.012) and was more frequent in skin type II (2.7%), when compared with skin types III (1.3%) and IV (0%). Conclusions Development of new melanocytic nevi may occur in pregnant women. The majority of the preexisting melanocytic nevi showed enlarging, and most of them presented with benign dermoscopic changes. The appearance of new streaks is more frequent in fair skin types. Patients with a personal or family history of melanoma in first-degree relatives presented more nevi with changes in size.
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Affiliation(s)
- Gabriela M Martins-Costa
- Postgraduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
| | - Renato Bakos
- Postgraduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil.,Department of Dermatology, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
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Gupta SK, Kumar A, Gupta V, Thakur A. Acral, Superficial Spreading Melanoma Arising on Melanocytic Nevus in a Pregnant Woman: A Case Report with Review. Indian J Dermatol 2015; 60:609-12. [PMID: 26677279 PMCID: PMC4681204 DOI: 10.4103/0019-5154.169138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
We are reporting a case of superficial spreading melanoma (SSM) on left palm of a 37-year-old pregnant housewife. She had a small acquired melanocytic nevus on her left palm since childhood, which changed its consistency and color in the last 4 months. Dermoscopy of the lesion indicated malignant changes. The lesion was managed surgically using split-thickness skin graft. The histopathology report was suggestive of SSM with positive HMB-45 cells. SSM is very rare on the acral site, and it is very difficult to differentiate it from acral lentiginous melanoma. The rarity of the site (acral nonchronic sun damage) with evolution during pregnancy and importance of management approach are reasons for publishing this case.
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Affiliation(s)
- Sunil Kumar Gupta
- Department of Skin, VD and Leprosy, Hind Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ajay Kumar
- Department of Surgery, Hind Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Vivek Gupta
- Department of Pathology, Hind Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Alpna Thakur
- Department of Skin, VD and Leprosy, Hind Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Auriemma M, Di Nicola M, Varrati S, Carbone A, Pamio A, Capo A, Tracanna M, Castigliego AP, Tiboni GM, Amerio P. Mole modifications following controlled ovarian stimulation for assisted reproduction technologies. J Eur Acad Dermatol Venereol 2015; 29:1913-7. [PMID: 25879151 DOI: 10.1111/jdv.13065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Accepted: 02/04/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND The role of estrogens on moles biology remains undefined although estrogenic receptors have been found on melanocytes. It has been postulated that supraphysiological estrogen levels could promote the progression of moles to melanoma. Women undergoing controlled ovarian stimulation (COS) for assisted reproductive technologies (ART) are exposed to high levels of estrogens, produced by the ovary in response to exogenous gonadotropin administration. The aim of this study is to assess whether COS for ART may have an impact on mole structure and/or characteristics. METHODS Women undergoing to ART for various infertility conditions were included in the study. Personal and clinical data were collected. Dermatoscopic features and scores (total dermoscopy score--TDS) were statistically compared before COS and after a 6-month follow-up period. Statistical correlation was performed between estradiol, FSH blood levels and relative variation in moles dimensions. RESULTS A total of 46 patients were included in the study. One hundred and seventy-five melanocytic lesions from 31 patients were evaluated at both time points. Although statistically significant differences were found in mole dimension and TDS between the two time points, these differences had no relevance in the clinical setting not suggesting the need for mole excision. Moreover, the only statistically significant correlation with estradiol blood concentration on hCG administration day was found with one-axis dimensional variation. CONCLUSIONS To our knowledge this is the first work to evaluate the effect of COS on moles. The obtained results do not support a causal relation between the supraphysiological hormone levels stimulation and worsening of clinical and dermoscopical features of moles. Further study is needed to clarify whether estrogens plays a role in melanoma.
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Affiliation(s)
- M Auriemma
- Department of Medicine and Aging Science and Dermatologic Clinic, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italy
| | - M Di Nicola
- Department of Experimental and Clinical Sciences, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italy
| | - S Varrati
- Department of Medicine and Aging Science and Dermatologic Clinic, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italy
| | - A Carbone
- L'Immacolata Hospital, Catholic University of the Sacred Heart, Celano (AQ), Italy
| | - A Pamio
- Department of Medicine and Aging Science, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italy
| | - A Capo
- Department of Medicine and Aging Science and Dermatologic Clinic, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italy
| | - M Tracanna
- Department of Medicine and Aging Science and Dermatologic Clinic, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italy
| | - A P Castigliego
- Department of Medicine and Aging Science, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italy
| | - G M Tiboni
- Department of Medicine and Aging Science, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italy
| | - P Amerio
- Department of Medicine and Aging Science and Dermatologic Clinic, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italy
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Hassan I, Bashir S, Taing S. A clinical study of the skin changes in pregnancy in kashmir valley of north India: a hospital based study. Indian J Dermatol 2015; 60:28-32. [PMID: 25657393 PMCID: PMC4318058 DOI: 10.4103/0019-5154.147782] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: Pregnancy is associated with multiple skin changes, most of which are physiological in nature, being the direct result of expected modifications of the hormonal, vascular, metabolic or immunologic status in pregnant females. Pregnancy however is also associated with certain pruritic eruptions, which not only cause distress to the pregnant female, but may influence the fetal outcome as well. Objective: The objective of this study was to determine the pattern of skin changes associated with pregnancy and to identify the various clinical types of pregnancy specific dermatoses (PSDs). Materials and Methods: The study was a cross sectional study carried out at the out-patient Department of Gynecology and obstetrics of our hospital. A total of 650 pregnant females, irrespective of their parity and gestational age were screened for the presence of any dermatological complaint. Results: The age of the study population ranged from 17 to 39 years (mean age: 24 years). The study population included 272 (42%) primigravidae and 378 (58%) multigravidae. Physiological skin changes of pregnancy were seen in all patients, out of which linea nigra was the most common change, seen in 520 (80%) cases. Specific dermatoses of pregnancy were seen in 32 (4.9%) cases, which included (in the decreasing order of frequency) prurigo of pregnancy (50% cases), intrahepatic cholestasis of pregnancy (25% cases), polymorphic eruption of pregnancy (22% cases) and pemphigus gestationis (3% cases). Conclusion: Skin changes were seen in 100% of pregnant females in this study, the major proportion being formed by physiological skin changes of pregnancy though PSDs were also seen in a significant number.
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Affiliation(s)
- Iffat Hassan
- Department of Dermatology, STD, Leprosy, Government Medical College, Srinagar (University of Kashmir), Jammu and Kashmir, India ; Department of Gynaecology and Obstetrics, Government Medical College, Srinagar (University of Kashmir), Jammu and Kashmir, India
| | - Safia Bashir
- Department of Dermatology, STD, Leprosy, Government Medical College, Srinagar (University of Kashmir), Jammu and Kashmir, India ; Department of Gynaecology and Obstetrics, Government Medical College, Srinagar (University of Kashmir), Jammu and Kashmir, India
| | - Shahnaaz Taing
- Department of Dermatology, STD, Leprosy, Government Medical College, Srinagar (University of Kashmir), Jammu and Kashmir, India ; Department of Gynaecology and Obstetrics, Government Medical College, Srinagar (University of Kashmir), Jammu and Kashmir, India
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Kvaskoff M, Bijon A, Mesrine S, Vilier A, Baglietto L, Fournier A, Clavel-Chapelon F, Dossus L, Boutron-Ruault MC. Association between melanocytic nevi and risk of breast diseases: The French E3N prospective cohort. PLoS Med 2014; 11:e1001660. [PMID: 24915306 PMCID: PMC4051602 DOI: 10.1371/journal.pmed.1001660] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 04/30/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND While melanocytic nevi have been associated with genetic factors and childhood sun exposure, several observations also suggest a potential hormonal influence on nevi. To test the hypothesis that nevi are associated with breast tumor risk, we explored the relationships between number of nevi and benign and malignant breast disease risk. METHODS AND FINDINGS We prospectively analyzed data from E3N, a cohort of French women aged 40-65 y at inclusion in 1990. Number of nevi was collected at inclusion. Hazard ratios (HRs) for breast cancer and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression models. Associations of number of nevi with personal history of benign breast disease (BBD) and family history of breast cancer were estimated using logistic regression. Over the period 15 June 1990-15 June 2008, 5,956 incident breast cancer cases (including 5,245 invasive tumors) were ascertained among 89,902 women. In models adjusted for age, education, and known breast cancer risk factors, women with "very many" nevi had a significantly higher breast cancer risk (HR = 1.13, 95% CI = 1.01-1.27 versus "none"; ptrend = 0.04), although significance was lost after adjustment for personal history of BBD or family history of breast cancer. The 10-y absolute risk of invasive breast cancer increased from 3,749 per 100,000 women without nevi to 4,124 (95% CI = 3,674-4,649) per 100,000 women with "very many" nevi. The association was restricted to premenopausal women (HR = 1.40, ptrend = 0.01), even after full adjustment (HR = 1.34, ptrend = 0.03; phomogeneity = 0.04), but did not differ according to breast cancer type or hormone receptor status. In addition, we observed significantly positive dose-response relationships between number of nevi and history of biopsy-confirmed BBD (n = 5,169; ptrend<0.0001) and family history of breast cancer in first-degree relatives (n = 7,472; ptrend = 0.0003). The main limitations of our study include self-report of number of nevi using a qualitative scale, and self-reported history of biopsied BBD. CONCLUSIONS Our findings suggest associations between number of nevi and the risk of premenopausal breast cancer, BBD, and family history of breast cancer. More research is warranted to elucidate these relationships and to understand their underlying mechanisms.
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Affiliation(s)
- Marina Kvaskoff
- “Nutrition, Hormones and Women's Health” Team, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), F-94805, Villejuif, France
- Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Cancer Control Group, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- * E-mail:
| | - Anne Bijon
- “Nutrition, Hormones and Women's Health” Team, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), F-94805, Villejuif, France
- Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Sylvie Mesrine
- “Nutrition, Hormones and Women's Health” Team, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), F-94805, Villejuif, France
- Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Alice Vilier
- “Nutrition, Hormones and Women's Health” Team, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), F-94805, Villejuif, France
- Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Laura Baglietto
- Cancer Epidemiology Centre, Cancer Council of Victoria, Melbourne, Victoria, Australia
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Victoria, Australia
| | - Agnès Fournier
- “Nutrition, Hormones and Women's Health” Team, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), F-94805, Villejuif, France
- Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Françoise Clavel-Chapelon
- “Nutrition, Hormones and Women's Health” Team, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), F-94805, Villejuif, France
- Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Laure Dossus
- “Nutrition, Hormones and Women's Health” Team, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), F-94805, Villejuif, France
- Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- “Nutrition, Hormones and Women's Health” Team, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), F-94805, Villejuif, France
- Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
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