Dermatología en Costa Rica

Wednesday, January 30, 2019

Mas de 3 lunares en una extremidad de más de 3 mm ...

Mas de 3 lunares en una extremidad de más de 3 mm confiere un riesgo 3.5 veces mayor de mortalidad por Melanoma especialmente en hombres.


Article in Press

Abstract

Background

It was unclear whether increased number of common nevi (moles) predicts melanoma death.

Objective

We prospectively examined the association between number of common nevi and risk of melanoma death

Methods

Our study was based on the Nurses' Health Study (n=77,288 women) and Health Professionals Follow-up Study (n=32,455 men). Number of moles with ≥3 mm diameter on the upper extremity was asked in 1986 and was re-classified into three categories (none, 1-2, or ≥3) based on data distribution.

Results

During follow-up (1986-2012), 2,452 melanoma cases were pathologically confirmed, among whom we identified 196 deaths due to melanoma. Increased number of nevi was associated with melanoma death; the hazard ratio (HR) for ≥3 nevi compared with no nevi was 2.49 [95% confidence interval(CI): 1.50-4.12] for women and 3.97 (95%CI: 2.54-6.22) for men. Among melanoma cases, increased number of nevi was associated with melanoma death in men (≥3 nevi: HR=1.89, 95%CI: 1.17-3.05), but not in women. Similarly, number of nevi was positively associated with Breslow thickness in men only (Ptrend=0.01).

Limitations

This is an epidemiologic study without examination into mechanisms.

Conclusions

Increased number of cutaneous nevi was significantly associated with melanoma death. High nevi count may serve as an independent prognostic factor, which predicts the risk of melanoma death particularly among male melanoma cases.

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