Risk of Melanoma in Patients With Congenital Melanocytic Nevi of All Sizes Journal of the European Academy of Dermatology and Venereology

TAKE-HOME MESSAGE

• This systematic review and meta-analysis examined the literature on congenital melanocytic nevi (CMN) to determine the risk of melanoma development in these lesions. The overall incidence density was 0.057% person-years. In patients with small- or medium-sized CMN, the median age at melanoma onset was 22 years. Melanomas were typically cutaneous, located on the trunk, and associated with large or giant CMN.

• Dermatologists should be aware of the risks and features of melanoma development in patients with CMN.

–  Joshua R. Ortego, MD

Written by

 

 

Thy N. Huynh MD, FAAD

This systemic review corroborates the previous findings that congenital melanocytic nevi (CMN) are known risk factors for early childhood development of melanoma, particularly in large and giant CMNs on axial body locations, especially on the trunk. Removal of large and giant CMNs is a therapeutic challenge. While the risk is not zero for medium CMNs, it is still relatively low risk and reassuring. Risk of melanoma for small CMNs could not be ascertained here, although previous studies have highlighted that a single small CMN also confers very low risk; multiple CMNs would increase the risk.1 It is beneficial to counsel all patients with CMNs (special emphasis and attention to those with projectedlarge/giant CMNs) and their family members on the ABCDEs of nevi/moles and sun-protective measures.

Reference

1. Kinsler VA, O'Hare P, Bulstrode N, et al. Melanoma in congenital melanocytic naevi. Br J Dermatol. 2017;176(5):1131-1143. https://onlinelibrary.wiley.com/doi/10.1111/bjd.15301 

Abstract 

Congenital melanocytic nevi (CMN) are commonly encountered benign skin lesions in newborns. Larger CMN are associated with a higher lifetime risk of developing melanoma. However, the level of risk is unclear when CMN are small or medium-sized. Our objective was to assess melanoma risk in patients with CMN of all size categories. A literature review with meta-analysis was performed. Prevalence and incidence densities of melanoma at onset were calculated in the entire study population and according to CMN size, type of treatment, and location of the CMN. A total of 91 melanomas were reported in 7915 patients (1.15%, 95% CI 0.93-1.41). The overall incidence density was 0.057% person-years (CI95%, [0.044%-0.071%]. The risk ratio of melanoma incidence densities was 21.9 (95% CI, 8.55-56.3) in large to giant CMN compared to small to medium CMN at 15 years of age. The Incidence density was higher in CMN located on the trunk and as well as in those which were untreated or partially treated versus complete excision. Our review suggests patients with CMN of medium, large and giant size are at risk of melanoma, whereas the risk remains unknown for small CMN.

Journal of the European Academy of Dermatology and Venereology: JEADV

Risk of melanoma in congenital melanocytic nevi of all sizes: a systematic review

J Eur Acad Dermatol Venereol 2022 Sep 23;[EPub Ahead of Print], C Scard, H Aubert, M Wargny, L Martin, S Barbarot 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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