Risk of cutaneous malignant melanoma in patients with nonfamilial atypical nevi from a pigmented lesions clinic

doi:10.1016/S0190-9622(99)70564-5

Journal of the American Academy of Dermatology

Volume 40, Issue 5, May 1999, Pages 686-693

https://doi.org/10.1016/S0190-9622(99)70564-5 Get rights and content

Abstract

Background: Atypical nevi (AN) are regarded as a major risk factor for occurrence of malignant melanoma. Few studies report an increase in relative risk for melanoma in patients with nonfamilial AN. Objective: We measured the risk of melanoma in 195 patients with nonfamilial AN. Methods: In a retrospective follow-up study the number of newly diagnosed melanomas during follow-up were inventoried. Included patients were invited for skin screening and nevus count. Results: On the basis of our calculations, the relative risk for invasive melanoma in patients with nonfamilial AN, including those patients with a history of melanoma, is 41. For individuals with AN without a previously diagnosed melanoma, the relative risk was 37. Multivariate analysis did not reveal a specific risk factor for the occurrence of melanoma (including number of AN) because of small numbers. Invasive melanomas occurred in persons having 1, 5, 12, and 172 AN, respectively. Conclusion: An increased risk for invasive cutaneous malignant melanoma in patients with nonfamilial AN was established.(J Am Acad Dermatol 1999;40:686-93.)

Section snippets

PATIENTS AND METHODS

Since the start of the PLC in 1982, patients with AN were photographed during yearly follow-up. Not only total body slides but also detail slides of clinical AN were made. Of this photographed group all patients with at least 1 clinically suspected (or histologically verified) AN and a negative family history of melanoma (the “sporadic” types A, B, and C) were selected, 213 in number. Patients were included for analysis of melanoma risk from the moment they reached the age of 16. Patients

Composition of the study group

The group of 195 patients participating in the study was made up of 98 (50.3%) male patients and 97 (49.7%) female patients. Of 127 patients (65%) the diagnosis of AN had been verified by histology on earlier occasions. The mean age at entry was 29 years (range 16 to 66). Male patients were on average 5 years older than female patients at the time of their first visit to the PLC (mean age resp. 31.0, SD 10.5 vs 25.7, SD 9.2; t test 3.71, 193 degrees of freedom, P < .001). Of the 195 invited

DISCUSSION

In a retrospective follow-up study of patients attending a PLC in a university hospital in the Netherlands, patients with nonfamilial AN (Kraemer types A, B, and C) were found to be at increased risk of experiencing invasive cutaneous malignant melanoma. We found a relative risk of 41 compared with the general Dutch population for Kraemer groups A, B, and C. For patients without a personal and family history of malignant melanoma (Kraemer groups A and B) a relative risk of 37 was found. These

Acknowledgements

Special thanks to Viña Snijders for a critical reading of the manuscript.

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Risk of cutaneous malignant melanoma in patients with nonfamilial atypical nevi from a pigmented lesions clinic☆,☆☆

Abstract

Section snippets

PATIENTS AND METHODS

Composition of the study group

DISCUSSION

Acknowledgements

Lancet

Prev Med

Lancet

J Am Acad Dermatol

J Am Acad Dermatol

Lancet

Lancet

Mayo Clin Proc

Hum Pathol

J Am Acad Dermatol

Dysplastic nevi as risk markers of sporadic (non-familial) melanoma

Arch Dermatol

Marker and relative risk in a German population for developing malignant melanoma

Int J Dermatol

Common and dysplastic naevi as risk factors for cutaneous malignant melanoma in a Swedish population

Acta Derm Venereol (Stockh)

Origin of familial malignant melanomas from heritable melanocytic lesions

Arch Dermatol

Familial atypical multiple mole melanoma syndrome

J Med Genet

Precursor lesions in familial melanoma

Semin Oncol

Dysplastic nevus syndrome: a phenotypic association of sporadic cutaneous melanoma

Cancer