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Ilut PA, Camela E, Lallas K, Papageorgiou C, Manoli SM, Kyrgidis A, Liopyris K, Sgouros D, Apalla Z, Lallas A. The Natural Evolution of Nevi with Peripheral Globules. Dermatology 2023; 239:760-767. [PMID: 37279706 DOI: 10.1159/000531004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/02/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Peripheral globules (PG) in melanocytic lesions represent a concerning dermoscopic feature since they might be present in growing nevi and melanomas. Their natural evolution has not been fully elucidated, and an age-based management approach has been recommended. OBJECTIVES The aim of this study was to calculate the growth rate of lesions with PG and investigate possible association with age, sex, location, and the global dermoscopic pattern. METHODS We retrospectively selected the lesions of interest from a cohort of Caucasian patients who underwent sequential digital dermoscopy monitoring. Lesions with PG distributed at 75% or more of their circumference with available follow-up images or histopathologic report were included. The surface area was automatically calculated with the help of an incorporated tool used in the acquisition of the images. The images were also evaluated by independent investigators for the presence of pre-defined criteria. Growth-curve models were used to assess the growth rate. The outcome variable was the area of nevi in mm2, and scatterplots with Lowess curves were used to present the mean change of nevi during follow-up. RESULTS A total of 208 lesions from 98 patients with a median age of 36 years (range 15-75) were included. The median follow-up time was 18 months (range 4-48). The mean growth rate for all nevi was 0.16 mm2/month (95% CI, 0.14-0.18, p < 0.001), ranging from -0.29 to 0.61 mm2/month. The growth rate was higher in nevi with a homogeneous dermoscopic pattern (p < 0.001). The number of peripheral globules during follow-up varied from increasing to complete disappearance. None of the lesions developed any melanoma-specific structure at follow-up. CONCLUSION Nevi with PG grew at a mean rate of 0.16 mm2/month, and the growth rate was independent of age, gender, or anatomic location. Nevi with homogeneous pattern demonstrated the highest growth rate in our cohort. None of the monitored nevi with PG developed melanoma-specific criteria at follow-up.
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Affiliation(s)
- Paula Anca Ilut
- Department of Dermatology, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Elisa Camela
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Konstantinos Lallas
- Department of Medical Oncology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Chryssoula Papageorgiou
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Sofia-Magdalini Manoli
- First Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Athanassios Kyrgidis
- Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, General Hospital of Thessaloniki "George Papanikolaou,", Thessaloniki, Greece
| | - Konstantinos Liopyris
- Department of Dermatology, University of Athens, Andreas Sygros Hospital for Cutaneous and Venereal Diseases, Athens, Greece
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Dimitrios Sgouros
- Second Department of Dermatology and Venereology, ATTIKON General University Hospital, Medical School, National and Kapodistrian University, Athens, Greece
| | - Zoe Apalla
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Aimilios Lallas
- First Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
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Jayasinghe D, Koh U, Plasmeijer EI, Menzies SW, Aitken JF, Soyer HP, Janda M, Green AC, Betz-Stablein B. The dynamic nature of naevi in adulthood: prospective population-based study using three-dimensional total-body photography. Br J Dermatol 2023; 188:437-439. [PMID: 36763731 DOI: 10.1093/bjd/ljac095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/03/2022] [Accepted: 11/26/2022] [Indexed: 01/22/2023]
Affiliation(s)
- Dilki Jayasinghe
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Uyen Koh
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Elsemieke I Plasmeijer
- Cancer and Population Studies, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Netherlands Cancer Institute, Department of Dermatology, Amsterdam, the Netherlands
| | - Scott W Menzies
- Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia.,Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Joanne F Aitken
- Cancer Council Queensland, Brisbane, QLD, Australia.,School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - H Peter Soyer
- The University of Queensland Diamantina Institute, The University of Queensland, Dermatology Research Centre, Brisbane, QLD, Australia.,Dermatology Department, Princess Alexandra Hospital, Brisbane, QLD, Australia.,Australian Skin and Skin Cancer Research Centre, Brisbane, QLD, Australia
| | - Monika Janda
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Australian Skin and Skin Cancer Research Centre, Brisbane, QLD, Australia
| | - Adele C Green
- Cancer and Population Studies, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Australian Skin and Skin Cancer Research Centre, Brisbane, QLD, Australia.,CRUK Manchester Institute and University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Brigid Betz-Stablein
- Cancer and Population Studies, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,The University of Queensland Diamantina Institute, The University of Queensland, Dermatology Research Centre, Brisbane, QLD, Australia
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Reiter O, Kurtansky N, Musthaq S, Dusza S, Halpern A, Marchetti M, Marghoob A, Scope A, Rotemberg V. The long-term evolution of melanocytic nevi among high-risk adults. J Eur Acad Dermatol Venereol 2022; 36:2379-2387. [PMID: 35881111 PMCID: PMC9804380 DOI: 10.1111/jdv.18470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/15/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND There is little understanding regarding the long-term natural history of melanocytic nevi among adults. OBJECTIVE The objective of the study was to describe the long-term natural history of individual nevi located on the torso of high-risk patients. METHODS All patients attending Memorial Sloan Kettering Cancer Center (MSKCC) who underwent two total body photography (TBP) sessions 15+ years apart were included ('retrospective' group). To account for a potential selection bias, we also included consecutive patients who had TBP 15+ years ago and consented to undergo follow-up TBP ('prospective' group). We compared baseline and follow-up torso images on the TBPs and evaluated the number of total, new and disappearing nevi; number of seborrheic keratoses and actinic keratoses; each nevus' diameter at both time points; each nevus' colour change; the presence of clinical atypia; and when dermoscopy was available, the dermoscopic features at each time point. RESULTS One hundred six patients were included in the study. Although the average age of the patients was 40 at baseline TBP, most patients developed new nevi between imaging sessions (median 16.4 years) with an average of 2.6 (SD = 4.8) nevi per participant. The average number of disappearing nevi was 0.3 (SD = 0.6). In addition, 62/106 (58%) patients had an absolute increase, and 9/106 (8%) patients had an absolute decrease in their total nevus count. Roughly half (49%: 1416/2890) of the nevi that could be evaluated at both time points increased in diameter by at least 25%. Only 6% (159/2890) of nevi shrunk in diameter by at least 25%. Patients with a history of melanoma had a higher rate of disappearing nevi, and their nevi were more likely to grow. Most nevi demonstrated no significant dermoscopic changes. CONCLUSIONS High-risk patients acquire new nevi throughout life with very few nevi disappearing over time. Contrary to prior reports, most nevi in adults increase in diameter, while few nevi shrink.
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Affiliation(s)
- O. Reiter
- Dermatology ServiceMemorial Sloan Kettering Cancer CenterNew YorkNYUSA,Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - N.R. Kurtansky
- Dermatology ServiceMemorial Sloan Kettering Cancer CenterNew YorkNYUSA
| | - S.T. Musthaq
- Dermatology ServiceMemorial Sloan Kettering Cancer CenterNew YorkNYUSA
| | - S. Dusza
- Dermatology ServiceMemorial Sloan Kettering Cancer CenterNew YorkNYUSA
| | - A.C. Halpern
- Dermatology ServiceMemorial Sloan Kettering Cancer CenterNew YorkNYUSA
| | - M.A. Marchetti
- Dermatology ServiceMemorial Sloan Kettering Cancer CenterNew YorkNYUSA
| | - A.A. Marghoob
- Dermatology ServiceMemorial Sloan Kettering Cancer CenterNew YorkNYUSA
| | - A. Scope
- Dermatology ServiceMemorial Sloan Kettering Cancer CenterNew YorkNYUSA,Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael,The Kittner Skin Cancer Screening and Research InstituteSheba Medical CenterRamat GanIsrael
| | - V. Rotemberg
- Dermatology ServiceMemorial Sloan Kettering Cancer CenterNew YorkNYUSA
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Kretschmer L, Schnabel V, Kromer C, Bauer-Büntzel C, Richter A, Bremmer F, Kück F, Julius K, Mitteldorf C, Schön MP. Melanocytic nevi in sentinel lymph nodes: association with cutaneous nevi and clinical relevance in patients with cutaneous melanomas. J Cancer Res Clin Oncol 2022; 148:3125-3134. [PMID: 35059868 PMCID: PMC9508010 DOI: 10.1007/s00432-021-03894-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 12/19/2021] [Indexed: 10/26/2022]
Abstract
PURPOSE Melanocytic nevi in lymph nodes (NNs) are an important histological differential diagnosis of initial sentinel lymph node (SN) metastasis in melanoma. Our aim was to associate NN in SNs with clinicopathologic features and survival rates in 1, 250 patients with SN biopsy for melanoma. METHODS To compare patients with present and absent NN, we used Fisher's exact test, Mann-Whitney U test, and multivariate logistic regression models in this retrospective observational study based on a prospectively maintained institutional database. RESULTS NN prevalence in axillary, cervical, and groin SNs was 16.5%, 19.4%, and 9.8%, respectively. NN were observed in combination with all growth patterns of melanoma, but more frequently when the primary was histologically associated with a cutaneous nevus. We observed a decreasing NN prevalence with increasing SN metastasis diameter. Multiple logistic regression determined a significantly increased NN probability for SNs of the neck or axilla, for individuals with ≥ 50 cutaneous nevi, midline primary melanomas, and for individuals who reported non-cutaneous malignancies in their parents. Cancer in parents was also significantly more frequently reported by melanoma patients who had more than 50 cutaneous nevi. In SN-negative patients, NN indicated a tendency for slightly lower melanoma-specific survival. CONCLUSIONS We found a highly significant association between NN diagnosis and multiple cutaneous nevi and provided circumstantial evidence that cutaneous nevi in the drainage area of lymph nodes are particularly important. The trend toward lower melanoma-specific survival in SN-negative patients with NN suggests that careful differentiation of SN metastases is important.
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Affiliation(s)
- Lutz Kretschmer
- Department of Dermatology, Venereology and Allergology, University Medical Center, Robert Koch Str. 40, 37075, Göttingen, Germany.
| | - Viktor Schnabel
- Department of Dermatology, Venereology and Allergology, University Medical Center, Robert Koch Str. 40, 37075, Göttingen, Germany
| | - Christian Kromer
- Department of Dermatology, Venereology and Allergology, University Medical Center, Robert Koch Str. 40, 37075, Göttingen, Germany
| | - Christoph Bauer-Büntzel
- Department of Nephrology and Hypertension, Center for Internal Medicine and Medical Clinic III, Klinikum Fulda, Fulda, Germany
| | - Annika Richter
- Institute of Pathology, University Medical Center, Göttingen, Germany
| | - Felix Bremmer
- Institute of Pathology, University Medical Center, Göttingen, Germany
| | - Fabian Kück
- Department of Medical Statistics, University Medical Center, Göttingen, Germany
| | - Katharina Julius
- Department of Dermatology, Venereology and Allergology, University Medical Center, Robert Koch Str. 40, 37075, Göttingen, Germany
| | - Christina Mitteldorf
- Department of Dermatology, Venereology and Allergology, University Medical Center, Robert Koch Str. 40, 37075, Göttingen, Germany
| | - Michael P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center, Robert Koch Str. 40, 37075, Göttingen, Germany
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Senet P. Quoi de neuf en dermatologie clinique ? ANNALES DE DERMATOLOGIE ET DE VÉNÉRÉOLOGIE - FMC 2021. [PMCID: PMC8675603 DOI: 10.1016/s2667-0623(21)01524-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- P. Senet
- Service de dermatologie, AP-HP, hôpital Tenon, Paris
- Adresse e-mail : (P. Senet)
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Reiter O, Musthaq S, Kurtansky NR, Barrios DM, Halpern AC, Marchetti MA, Marghoob AA, Nanda JK, Stoll J, Rotemberg V. Suggested methodology for longitudinal evaluation of nevi based on clinical images. Skin Res Technol 2021; 28:71-74. [PMID: 34455638 PMCID: PMC9907704 DOI: 10.1111/srt.13092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 07/31/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Melanoma screening includes the assessment of changes in melanocytic lesions using images. However, previous studies of normal nevus temporal changes showed variable results and the optimal method for evaluating these changes remains unclear. Our aim was to evaluate the reproducibility of (a) nevus count done at a single time point (method I) versus two time points (method II); and (b) manual and automated nevus diameter measurements. MATERIALS AND METHODS In a first experiment, participants used either a single time point or a two time point annotation method to evaluate the total number and size of nevi on the back of an atypical mole syndrome patient. A Monte Carlo simulation was used to calculate the variance observed. In a second experiment, manual measurements of nevi on 2D images were compared to an automated measurement on 3D images. Percent difference in the paired manual and automated measurements was calculated. RESULTS Mean nevus count was 137 in method I and 115.5 in method II. The standard deviation was greater in method I (38.80) than in method II (4.65) (p = 0.0025). Manual diameter measurements had intraclass correlation coefficient of 0.88. The observed mean percent difference between manual and automated diameter measurements was 1.5%. Lightly pigmented and laterally located nevi had a higher percent difference. CONCLUSIONS Comparison of nevi from two different time points is more consistent than nevus count performed separately at each time point. In addition, except for selected cases, automated measurements of nevus diameter on 3D images can be used as a time-saving reproducible substitute for manual measurement on 2D images.
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Affiliation(s)
- Ofer Reiter
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, USA.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shenara Musthaq
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | | | - Dulce M Barrios
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Allan C Halpern
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | | | - Ashfaq A Marghoob
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Japbani K Nanda
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Joseph Stoll
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Veronica Rotemberg
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, USA
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Di Brizzi EV, Pampena R, Licata G, Calabrese G, Longo C, Argenziano G. Are we born and do we die without nevi? A cross-sectional study. Int J Dermatol 2021; 60:1405-1410. [PMID: 33998695 DOI: 10.1111/ijd.15668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 03/06/2021] [Accepted: 04/22/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND It is well known that the number of nevi varies with age. However, there are a few data in the literature concerning total nevus count at different ages. The aim of this study was to assess and compare the total nevus count among different age groups. METHODS The total nevus count was assessed in consecutive patients belonging to nine age groups. Median nevus count was calculated and compared for each age group. Multivariate logistic regression analysis was used to define the influence of sex and phototype on the association between nevus count and age. RESULTS We enrolled 900 patients (461, 51.2% females), with a median age of 46 years and a total of 18,136 nevi. Significant differences were found in the median total nevus count among all age groups (P < 0.001), with a significant increase in the first two decades and a significant decrease after the age of 50 years. A similar trend was also observed in subgroups. The differences observed in the total body nevus count among age groups were independent of sex and phototype. CONCLUSIONS We demonstrate that the total nevus count significantly increases during childhood and gradually decreases in the elderly.
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Affiliation(s)
| | - Riccardo Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | | | - Caterina Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Department of Dermatology, University of Modena, Reggio Emilia, Italy
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Cust A. A different finding on whether naevus numbers change during adulthood. Br J Dermatol 2020; 184:193. [DOI: 10.1111/bjd.19619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 02/05/2023]
Affiliation(s)
- A.E. Cust
- Sydney School of Public Health and the Melanoma Institute Australia The University of Sydney Sydney NSW Australia
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