Melanocytic nevi in 2783 children and adolescents in Turkey

Anchored Suture Technique for the Reconstruction of Paranasal Skin Defects Secondary to Melanocytic Nevus Excision

To describe a modified anchored suture technique combined with varied flaps for the repair of paranasal skin defect secondary to melanocytic nevus excision. The feasibility and effectiveness of the technique were discussed. A total of 26 patients (10 male and 16 female) with an average age of 11.1 years were included in this retrospective study. All patients underwent the anchored suture technique. The subcutaneous tissue of the free margin of the cheek flap was sutured to the deep pyriform ligament. The local flaps were designed according to the size and shape of the defect. The diameter of the nevi ranged from 2.8 to 7.5 cm, with most being 3 to 5 cm (50%). Among the 26 patients, 17 patients underwent the anchored suture technique and nonadvancement flap, whereas the other 9 patients underwent the anchored suture technology and advancement flap with auxiliary incisions. Twenty-five patients had a symmetric nasal alar and unapparent scar and were satisfied with postoperative aesthetic outcomes. Thus, the anchored suture method combined with different flaps to repair paranasal defect is an effective and affordable technique to reconstruct paranasal tissue connections.

Reconstruction of Cutaneous Nasal Alar Defects Following Melanocytic Nevus Resection

OBJECTIVE

The reconstruction of nasal alar defects after resection of a melanocytic nevus becomes one of the most challenging procedures for surgeons. Choosing the most appropriate technique is still difficult sometimes. The authors reviewed our cases and published experience on choosing optimal surgical methods to repair different types of nasal alar defect following melanocytic nevus resection.

METHODS

A total of 152 patients who were treated between 2016 and 2019 in Shanghai Ninth People's Hospital were evaluated. The surgical methods included primary closure, full-thickness skin graft, composite auricular graft, interpolated melolabial flap, paramedian forehead flap including hair-bearing paramedian forehead flap.

RESULTS

Among the 152 patients with a melanocytic nevus, 49 underwent primary closure, 38 were treated with a full-thickness skin graft, 16 composite auricular graft, 28 were treated with interpolated melolabial flap, and 21were treated with paramedian forehead flap including 14 with hair-bearing paramedian forehead flap. Most skin graft, composite auricular graft, and flaps were survived. Patients who completed follow-up were satisfied with the contour of the nasal ala.

CONCLUSIONS

After resection of the melanocytic nevus, the surgeon should choose the most appropriate surgical method for alar reconstruction according to the characteristics of the defect and personal desire of patient or the guardian.

Melanocytic lesion in children and adolescents: an Italian observational study

Malignant melanoma is a rare neoplasm in the pediatric age group. One of the main risks factors is represented by the presence of a high number of melanocytic nevi. Sun exposure in pediatric age represents a predictor of melanocytic nevi number in the adult age and there is a direct correlation between the presence of melanocytic moles in early childhood and the development of many nevi in adults, suggesting that a high number of nevi in childhood should be considered as a predictor of melanoma development during adult life. The predominance of dermoscopic types of melanocytic nevi varies according to the individual’s age and depends on endogenous or exogenous signaling, suggesting different pathways of nevogenesis. We evaluated the total amount of melanocytic nevi of pediatric patients and their prevalent dermoscopic pattern. We investigated the reasons for dermatological examination, pointing out the role of older parents’ populations in the decision to refer to a dermatological consultant. We performed a prospective observational study on 295 pediatric outpatients consecutively enrolled from July 2018 to July 2019. Descriptive and inferential statistical analyses were performed using logistic and linear regression. 49% of children were characterized by less than 10 nevi, 45% of children by a number of nevi between 10 and 30, whilst 17 patients (5%) had a number of nevi between 30 and 50. The most prevalent dermoscopic pattern was the globular one. An older parenting age was correlated with an autonomous reason for referral and a later first visit. Our data agreed with previous suggestions demonstrating a strong influence of latitude, sun exposure and ethnic background in the development of the number of nevi. To our knowledge, this is the first study, which evaluated the reasons for dermatological examination and the role of older parents’ populations in the decision to refer to a dermatological consultant

Visual scales are superior to questionnaires in skin phototype self-assessment by children

BACKGROUND/PURPOSE

There are no suitable methods for skin phototype self-assessment by children. Our study investigated several skin phototype self-assessment methods in children to identify the best correlation to objectively measure skin phototype.

METHODS

Danish schoolchildren (ages 6-19) participated in a nation-wide study that assessed skin, eye, hair colour and sun behaviour. Skin phototype self-assessment was performed by children using two visual colour scales (cartoon faces and colour cards), question-based colour scale and questions about tendency to burn and ability to tan. For objective skin phototype measurements, 483 children from all age groups were selected and their pigment protection factor (PPF) was measured at three skin sites using a skin reflectance spectrophotometer.

RESULTS

Cartoon faces (r²  = 0.654) and colour cards (r²  = 0.659) were better at predicting PPF on the inner forearm than the question-based colour method (r²  = 0.520). PPF prediction from questions on skin reaction to sun exposure was markedly inferior (r²  ≤ 0.142) to both visual colour scales and question-based colour method.

CONCLUSION

Both visual colour scales proved to be superior to question-based skin phototype self-assessment in schoolchildren. In contrast, questions on skin reaction to sun exposure were shown to be an unsuitable tool for self-assessment of skin phototype in children.

Dermatological Findings in Turkish Paediatric Haematology-Oncology Patients

OBJECTIVE

Diagnoses of skin, mucosae, hair and nail manifestations in malignant diseases are often challenging because of life-threatening drug reactions, opportunistic infections or skin involvement of primary processes. Description of morphology, configuration and distribution of lesions is important in order to differentiate the self-healing eruptions from serious side effects of chemotherapy. There are case reports from Turkey including dermatological manifestations of malignancies and case series in adult patients but there are no published large group studies assessing all manifestations in children. The aim of this study was to evaluate the morphological features of dermatological findings in children with haemato-oncological diseases.

MATERIALS AND METHODS

The study was performed at the Erciyes University, Faculty of Medicine Pediatric Hematology-Oncology Clinic, Turkey. Three dermatologists daily consulted all patients admitted to the clinic during a one-year period.

RESULTS

The study group comprised of 157 children (79 female/78 male) aged 1-16 years (mean 7.19±4.63). Detailed dermatological examinations were performed, including oral-genital mucosae, hair and nails. Thorough skin examination revealed that 70% of the patients exhibited at least one dermatological finding. Generalized xerosis and hyperpigmentation were the most common findings among patients undergoing chemotherapy (24.19%). Multiple nevi on at least 10 covered areas were very frequent among patients undergoing long-term chemotherapy (18.47%). Three were identified as dysplastic nevus, but malignant transformation was not observed during the one-year study period.

CONCLUSION

Regular dermatological consultation may help resolve the diagnostic and therapeutic problems in paediatric haemato-oncology clinics.

Clinical and dermoscopic stability and volatility of melanocytic nevi in a population-based cohort of children in Framingham school system

Nevi are important risk markers of melanoma. The study aim was to describe changes in nevi of children using longitudinal data from a population-based cohort. Overview back photography and dermoscopic imaging of up to 4 index back nevi was performed at age 11 (baseline) and repeated at age 14 (follow-up). Of 443 children (39% females) imaged at baseline, 366 children (39% females) had repeated imaging three year later. At age 14, median back nevus counts increased by 2; 75% of students (n=274) had at least one new back nevus and 28% (n=103) had at least one nevus that disappeared. Of 936 index nevi imaged dermoscopically at baseline and follow-up, 69% (645 nevi) had retained the same dermoscopic classification from baseline evaluation. Only 4% (n=13) of nevi assessed as globular at baseline were classified as reticular at follow-up, and just 3% (n=3) of baseline reticular nevi were classified as globular at follow-up. Of 9 (1%) index nevi that disappeared at follow-up, none showed halo or regression at baseline. In conclusion, the relative stability of dermoscopic pattern of individual nevi in the face of the overall volatility of nevi during adolescence suggests that specific dermoscopic patterns may represent distinct biologic nevus subsets.

Knowledge and perception of melanocytic nevi and sunburn in young children

BACKGROUND/OBJECTIVES

Understanding the public's perception of nevi and sunburn is crucial to melanoma prevention efforts.

METHODS

We investigated the knowledge and perception of melanocytic nevi and sunburns in 77 children 6 to 10 years old (mean 8.2) in two elementary schools in Styria, Austria. The children were interviewed by specially trained psychologists about the number of their moles and how they felt having them. Additionally questions about sunburn history and sunburn perception were asked. The spontaneous answers of the children were recorded, there were no pregiven answers. Afterwards the children were examined by dermatologists clinically and with dermatoscopes.

RESULTS

The 96% of the children could describe a nevus (the term "mole" was translated to "nevus") and 91% did not feel bothered about theirs. Only 26% had noted the appearance of new nevi within the last year. The 67% of all children had at least one sunburn and remembered the clinical features. The 20% of the children knew that sunburns could provoke skin cancer. All children felt comfortable during the clinical and dermatoscopic examination.

CONCLUSION

Children aged from 6 to 10 years know exactly why they had suffered from sunburn, can describe the sunburn and how to avoid it. They do not feel bothered by their nevi and are alert to the appearance of new nevi.