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The Complex Interplay between Nevi and Melanoma: Risk Factors and Precursors. Int J Mol Sci 2023; 24:ijms24043541. [PMID: 36834954 PMCID: PMC9964821 DOI: 10.3390/ijms24043541] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/30/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
One effort to combat the rising incidence of malignant melanoma is focused on early detection by the clinical and dermoscopic screening of melanocytic nevi. However, the interaction between nevi, which are congenital or acquired benign melanocytic proliferations, and melanoma is still enigmatic. On the one hand, the majority of melanomas are thought to form de novo, as only a third of primary melanomas are associated with a histologically identifiable nevus precursor. On the other hand, an increased number of melanocytic nevi is a strong risk factor for developing melanoma, including melanomas that do not derive from nevi. The formation of nevi is modulated by diverse factors, including pigmentation, genetic risk factors, and environmental sun exposure. While the molecular alterations that occur during the progression of a nevus to melanoma have been well characterized, many unanswered questions remain surrounding the process of nevus to melanoma evolution. In this review, we discuss clinical, histological, molecular, and genetic factors that influence nevus formation and progression to melanoma.
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Vassantachart JM, Zacher NC, Teng JMC. Eruptive nevi in a patient with constitutional mismatch repair deficiency (CMMRD). Pediatr Dermatol 2022; 39:91-93. [PMID: 34787334 DOI: 10.1111/pde.14861] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 09/09/2021] [Accepted: 10/29/2021] [Indexed: 12/13/2022]
Abstract
Biallelic mutations in the DNA mismatch repair genes MLH1, MSH2, MSH6, or PMS2 result in one of the most aggressive genetic cancer conditions, constitutional mismatch repair syndrome (CMMRD). We present a case of a 10-year-old boy with biallelic MSH6 mutation and systemic lupus erythematosus with eruptive melanocytic nevi after receiving chemotherapy for mediastinal T-cell lymphoblastic lymphoma.
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Affiliation(s)
| | - Natasha C Zacher
- Department of Dermatology, Stanford University, Stanford, California, USA
| | - Joyce M C Teng
- Department of Dermatology, Stanford University, Stanford, California, USA
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Abstract
Eruptive melanocytic nevi (EMN) is a phenomenon characterized by the sudden onset of nevi. Our objective was to compile all published reports of EMN to identify possible precipitating factors and to evaluate the clinical appearance and course. We conducted a systematic bibliographic search and selected 93 articles, representing 179 patients with EMN. The suspected causes were skin and other diseases (50%); immunosuppressive agents, chemotherapy or melanotan (41%); and miscellaneous, including idiopathic (9%). The clinical manifestations could largely be divided into two categories: EMN associated with skin diseases were frequently few in number (fewer than ten nevi), large, and localized to the site of previous skin disease, whereas those due to other causes presented most often with multiple small widespread nevi. In general, EMN seem to persist unchanged after their appearance, but development over several years or fading has also been reported. Overall, 16% of the cases had at least one histologically confirmed dysplastic nevus. Five cases of associated melanoma were reported. We conclude that the clinical appearance of EMN may differ according to the suggested triggering factor. Based on the clinical distinction, we propose a new subclassification of EMN: (1) widespread eruptive nevi (WEN), with numerous small nevi, triggered by, for example, drugs and internal diseases, and (2) Köbner-like eruptive nevi, often with big and few nevi, associated with skin diseases and most often localized at the site of previous skin disease/trauma. The nature of the data precluded assessment of risk of malignant transformation.
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O'Keeffe C, Hollywood A, Hanley B, Boggs J, Roche M, Feighery C. Eruptive melanocytic naevi provoked by sunbed use in a patient on systemic immunosuppression. Clin Exp Dermatol 2019; 45:273-274. [PMID: 31389065 DOI: 10.1111/ced.14067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2019] [Indexed: 11/28/2022]
Affiliation(s)
- C O'Keeffe
- Department of Dermatology, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland
| | - A Hollywood
- Department of Dermatology, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland
| | - B Hanley
- Department of Dermatology, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland
| | - J Boggs
- Department of Dermatology, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland
| | - M Roche
- Department of Dermatology, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland
| | - C Feighery
- Department of Dermatology, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland
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Kravvas G, Kavanagh GM. Eruptive melanocytic naevi secondary to azathioprine: case report and review of the literature. Clin Exp Dermatol 2017; 43:106-107. [PMID: 28994130 DOI: 10.1111/ced.13276] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2017] [Indexed: 11/26/2022]
Affiliation(s)
- G Kravvas
- Department of Dermatology, NHS Lothian, Edinburgh, UK
| | - G M Kavanagh
- Department of Dermatology, NHS Lothian, Edinburgh, UK
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Yang TH, Wang KH, Tsai HH, Chu JS. Eruptive melanocytic nevi with malignant transformations and the connection to BRAF and p16 mutations. DERMATOL SIN 2017. [DOI: 10.1016/j.dsi.2016.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Perry BM, Nguyen A, Desmond BL, Blattner CM, Thomas RS, Young RJ. Eruptive nevi associated with medications (ENAMs). J Am Acad Dermatol 2016; 75:1045-1052. [DOI: 10.1016/j.jaad.2016.04.064] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 04/21/2016] [Accepted: 04/24/2016] [Indexed: 10/21/2022]
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Vena GA, Fargnoli MC, Cassano N, Argenziano G. Drug-induced eruptive melanocytic nevi. Expert Opin Drug Metab Toxicol 2016; 13:293-300. [PMID: 27759434 DOI: 10.1080/17425255.2017.1247155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION The sudden eruption of melanocytic nevi has been associated with a number of conditions, such as bullous skin diseases, immunodeficiency and immunosuppression. The exact mechanisms leading to the development of eruptive melanocytic nevi are unknown. Areas covered: The aim of this article is to review the literature concerning eruptive melanocytic nevi following the administration of immunosuppressive drugs and other medications. Expert opinion: The literature regarding the development of eruptive nevi in association with pharmacological therapies includes a relatively low number of reports. Prevalence of this phenomenon is likely to be underestimated, thus reporting should be encouraged in order to better define the actual significance and related clinical implications. The development of multiple melanocytic nevi during immunosuppressive treatments highlights the importance of immune system integrity in the regulation of nevi growth. The observation of eruptive nevi as an unexpected effect of targeted therapies for specific types of cancer, including melanoma, provided intriguing hints to understand the mechanisms underlying this paradoxical event. The synergistic role of additional triggers in the occurrence of drug-induced eruptive nevi has not been explored and may be an interesting area of research.
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Affiliation(s)
- Gino A Vena
- a Dermatology and Venereology Private Practice , Bari and Barletta , Italy
| | | | - Nicoletta Cassano
- a Dermatology and Venereology Private Practice , Bari and Barletta , Italy
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Abstract
Melanomas on sun-exposed skin are heterogeneous tumours, which can be subtyped on the basis of their cumulative levels of exposure to ultraviolet (UV) radiation. A melanocytic neoplasm can also be staged by how far it has progressed, ranging from a benign neoplasm, such as a naevus, to a malignant neoplasm, such as a metastatic melanoma. Each subtype of melanoma can evolve through distinct evolutionary trajectories, passing through (or sometimes skipping over) various stages of transformation. This Review delineates several of the more common progression trajectories that occur in the patient setting and proposes models for tumour evolution that integrate genetic, histopathological, clinical and biological insights from the melanoma literature.
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Affiliation(s)
- A Hunter Shain
- University of California, San Francisco, Departments of Dermatology and Pathology and Helen Diller Family Comprehensive Cancer Center, Box 3111, San Francisco, CA 94143, USA
| | - Boris C Bastian
- University of California, San Francisco, Departments of Dermatology and Pathology and Helen Diller Family Comprehensive Cancer Center, Box 3111, San Francisco, CA 94143, USA
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Mazaud C, Chevallier B, Sigal ML, Mahé E. [Childhood eruptive nevi: a case report]. Arch Pediatr 2015; 22:409-13. [PMID: 25725971 DOI: 10.1016/j.arcped.2015.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 10/29/2014] [Accepted: 01/20/2015] [Indexed: 10/23/2022]
Abstract
"Eruptive nevi" is a phenomenon characterized by a rapid appearance of multiple melanocytic nevi. It is mainly developed in three groups of patients: those with systemic immunosuppression, bullous cutaneous disorders, and a melanocytic stimulation drug. We report on the case of an 11-year-old boy who was diagnosed with acute lymphoblastic leukemia. A few months after the beginning of the chemotherapy, he developed multiple pigmented lesions over the skin. Eruptive nevi syndrome has been described in the literature in 29 cases in the context of severe bullous disease and in immunosuppression. Nevi most often appear on the trunk and extremities, notably on the feet in the context of immunosuppression. They are localized in areas of bullous lesions in bullous diseases. Due to an increased melanocytic stimulation in eruptive nevi patients, long-term surveillance of individuals who have developed eruptive nevi is required, and increased sun prevention should be suggested.
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Affiliation(s)
- C Mazaud
- Service de dermatologie, hôpital Victor-Dupouy, 69, rue du Lieutenant Colonel Prudhon, 95100 Argenteuil, France
| | - B Chevallier
- Service de pédiatrie, université Versailles-SQY, hôpital Ambroise-Paré, Assistance publique-Hôpitaux de Paris, 9, avenue du Général-de-Gaulle, 92100 Boulogne-Billancourt, France
| | - M-L Sigal
- Service de dermatologie, hôpital Victor-Dupouy, 69, rue du Lieutenant Colonel Prudhon, 95100 Argenteuil, France
| | - E Mahé
- Service de dermatologie, hôpital Victor-Dupouy, 69, rue du Lieutenant Colonel Prudhon, 95100 Argenteuil, France.
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Bastian BC. The molecular pathology of melanoma: an integrated taxonomy of melanocytic neoplasia. ANNUAL REVIEW OF PATHOLOGY 2014; 9:239-71. [PMID: 24460190 PMCID: PMC4831647 DOI: 10.1146/annurev-pathol-012513-104658] [Citation(s) in RCA: 313] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Melanomas comprise multiple biologically distinct categories, which differ in cell of origin, age of onset, clinical and histologic presentation, pattern of metastasis, ethnic distribution, causative role of UV radiation, predisposing germ-line alterations, mutational processes, and patterns of somatic mutations. Neoplasms are initiated by gain-of-function mutations in one of several primary oncogenes, which typically lead to benign melanocytic nevi with characteristic histologic features. The progression of nevi is restrained by multiple tumor-suppressive mechanisms. Secondary genetic alterations override these barriers and promote intermediate or overtly malignant tumors along distinct progression trajectories. The current knowledge about the pathogenesis and clinical, histologic, and genetic features of primary melanocytic neoplasms is reviewed and integrated into a taxonomic framework.
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Affiliation(s)
- Boris C Bastian
- Departments of Dermatology and Pathology, Cardiovascular Research Institute, University of California, San Francisco, California 94158-9001;
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Salopek TG, Mahmood MN. Eruptive Melanocytic Nevi Induced by Interferon for Nodal Metastatic Melanoma: Case Report and Review of the Literature. J Cutan Med Surg 2013; 17:410-3. [DOI: 10.2310/7750.2013.13034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: The rapid appearance of multiple new melanocytic nevi is known as eruptive nevi and has been well documented to occur with certain medications, in particular chemotherapeutic agents. Methods: We report a case of a woman with melanoma complicated by nodal metastasis who developed multiple melanocytic nevi while on high-dose interferon. Results: Serial photographs confirmed that the pigmented lesions were of new onset, whereas histology documented that the lesions were dysplastic nevi. A survey of the literature documented numerous causes of eruptive nevi, which we review. To date, interferon has not been linked to eruptive nevi. Conclusions: The phenomenon of eruptive nevi has been attributed to medications, bullous dermatoses, immunosuppression, and systemic conditions and is possibly a paraneoplastic disorder. Interferon appears to be another possible cause of this disorder.
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Affiliation(s)
- Thomas G. Salopek
- From the Division of Dermatology and Cutaneous Sciences, Department of Medicine, and Division of Anatomical Pathology, Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB
| | - Muhammad N. Mahmood
- From the Division of Dermatology and Cutaneous Sciences, Department of Medicine, and Division of Anatomical Pathology, Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB
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Green J, Norris D, Wisell J. Novel cutaneous effects of combination chemotherapy with BRAF and MEK inhibitors: a report of two cases. Br J Dermatol 2013; 169:172-6. [DOI: 10.1111/bjd.12279] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2013] [Indexed: 01/07/2023]
Affiliation(s)
- J.S. Green
- Department of Dermatology; University of Colorado Denver; Anschutz Medical Campus, 1665 Aurora Court, Mail Stop F703 Aurora CO 80011 U.S.A
| | - D.A. Norris
- Department of Dermatology; University of Colorado Denver; Anschutz Medical Campus, 1665 Aurora Court, Mail Stop F703 Aurora CO 80011 U.S.A
- Denver Veterans Affairs Medical Center; Denver CO 80220 U.S.A
| | - J. Wisell
- Department of Dermatology; University of Colorado Denver; Anschutz Medical Campus, 1665 Aurora Court, Mail Stop F703 Aurora CO 80011 U.S.A
- Department of Pathology; University of Colorado Denver; Anschutz Medical Campus, 1665 Aurora Court, Mail Stop F703 Aurora CO 80011 U.S.A
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John JK, Smalley KSM. Identification of BRAF mutations in eruptive melanocytic nevi: new insights into melanomagenesis? Expert Rev Anticancer Ther 2011; 11:711-4. [PMID: 21554046 DOI: 10.1586/era.11.30] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Eruptive melanocytic nevi (EMN) is an unusual phenomenon characterized by the abrupt, simultaneous appearance of hundreds of melanocytic nevi on previously uninvolved sun-exposed skin. The mechanisms underlying this phenomenon are not well understood, but have been associated with both systemic immunosuppression and bullous dermatoses. The paper under evaluation brings new insight into the molecular events underlying EMN development in a patient receiving 6-mercaptopurine immunosuppressive therapy for ulcerative colitis. Sequencing of DNA from 20 eruptive nevi revealed the presence of BRAF V600E mutations in 85% of the lesions tested. The role of mutated BRAF in the initiation and progression of melanoma in conjunction with the strong correlation between nevus number and melanoma risk suggests the need for photoprotection in patients receiving thiopurine therapy. The study under evaluation further points to the possible interaction between environmental mutagens and UV radiation in the acquisition of BRAF mutations that may in turn increase the risk of melanoma development.
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Affiliation(s)
- Jobin K John
- Department of Molecular Oncology, The Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA
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de Boer NKH, Kuyvenhoven JP. Eruptive benign melanocytic naevi during immunosuppressive therapy in a Crohn's disease patient. Inflamm Bowel Dis 2011; 17:E26. [PMID: 21287668 DOI: 10.1002/ibd.21618] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 12/06/2010] [Indexed: 12/09/2022]
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Ross AL, Sanchez MI, Grichnik JM. Nevogenesis: a benign metastatic process? ISRN DERMATOLOGY 2011; 2011:813513. [PMID: 22363860 PMCID: PMC3262547 DOI: 10.5402/2011/813513] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2011] [Accepted: 03/08/2011] [Indexed: 11/23/2022]
Abstract
It is generally accepted that cutaneous nevogenesis is a localized event that occurs exclusively in the dermis and/or epidermis. However, the discovery of nevocytes circulating in the peripheral blood suggests that other, more systemic, benign metastatic processes could also be involved. The theoretical role of lymphatic and hematogenous dissemination of loosely adherent, immature nevus progenitor cells in the development of nodal nevi and eruptive melanocytic nevi will be reviewed.
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Affiliation(s)
- Andrew L Ross
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
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Research Snippets. J Invest Dermatol 2010. [DOI: 10.1038/jid.2010.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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