Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy,
Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
Dermatology. 2021;237(3):473-478. doi: 10.1159/000510221. Epub 2020 Oct 14.
Congenital melanocytic nevi (CMN) are benign proliferations of melanocytes usually present at birth. The magnitude of the melanoma risk for CMN is controversial, generating an ongoing debate on the best approach to manage these lesions.
To perform a retrospective, observational study with the aim to evaluate the prevalence of CMN-associated melanomas in tertiary referral centers, as well as the eventual correlation between clinical, dermoscopic, and histological features of CMN-associated melanomas.
A single-center retrospective observational study was performed on all clinical and dermoscopic images of histologically confirmed melanomas arising on CMN over a 14-year period (January 2005 to March 2019).
Our database included 2,159 melanomas in the considered period. Of those, 27 (1.3%) were CMN-associated melanomas. The mean age of patients with CMN-associated melanoma was 33 years (range, 11-70 years). The mean diameter of CMN-associated melanoma was 18 mm (range, 6 mm to 20 cm), and 56% were located on the back. Twenty-one (77.8%) of CMN-associated melanomas arose on small CMN (<1.5 cm), 5 (18.5%) on medium-sized CMN (1.5-19.9 cm), and 1 (3.7%) on a large/giant type (≥20 cm). The majority of CMN-associated melanomas (63%) exhibited a globular dermoscopic pattern in their benign part, while a blue-white veil and irregular blotches were the most frequent dermoscopic features in the malignant part. About three quarters of melanomas occupied 10-50% of the nevus surface. Breslow thickness was higher in melanomas involving less than 10% of nevus surface (mean thickness, 1 mm) than in those affecting 10-50 and >50% of the nevus surface (0.8 and 0.7 mm, respectively).
In our series, small CMN was the most frequent type of CMN-associated melanoma. Although the risk of melanoma is increasing by the increasing size of CMN, our finding is definitely related to the much higher prevalence of small CMN in the general population as compared to the prevalence of intermediate-sized and large CMN.
Small sample size, single-center experience, retrospective design.
先天性黑素细胞痣（CMN）是一种常见的黑素细胞良性增生，通常在出生时出现。CMN 相关黑色素瘤的风险程度存在争议，这引发了关于管理这些病变的最佳方法的持续争论。
进行一项回顾性、观察性研究，旨在评估三级转诊中心中 CMN 相关黑色素瘤的患病率，以及 CMN 相关黑色素瘤的临床、皮肤镜和组织学特征之间的潜在相关性。
对 14 年来（2005 年 1 月至 2019 年 3 月）经组织学证实的 CMN 上发生的黑色素瘤的所有临床和皮肤镜图像进行了单中心回顾性观察性研究。
我们的数据库包括在此期间的 2159 例黑色素瘤。其中，27 例（1.3%）为 CMN 相关黑色素瘤。CMN 相关黑色素瘤患者的平均年龄为 33 岁（范围 11-70 岁）。CMN 相关黑色素瘤的平均直径为 18 毫米（范围 6 毫米至 20 厘米），56%位于背部。21 例（77.8%）CMN 相关黑色素瘤起源于小 CMN（<1.5 厘米），5 例（18.5%）起源于中 CMN（1.5-19.9 厘米），1 例（3.7%）起源于大/巨型（≥20 厘米）。CMN 相关黑色素瘤的大部分（63%）良性部分表现为球形皮肤镜模式，而恶性部分最常见的皮肤镜特征是蓝白色面纱和不规则斑片。大约四分之三的黑色素瘤占据了 10-50%的痣表面。累及小于 10%痣表面的黑色素瘤（平均厚度为 1 毫米）的 Breslow 厚度高于累及 10-50%和>50%痣表面的黑色素瘤（分别为 0.8 和 0.7 毫米）。
在我们的系列中，小 CMN 是最常见的 CMN 相关黑色素瘤类型。尽管黑色素瘤的风险随着 CMN 大小的增加而增加，但我们的发现肯定与小 CMN 在普通人群中的高患病率有关，而与中 CMN 和大 CMN 的患病率无关。
样本量小、单中心经验、回顾性设计。
