A prospective study of patients with large congenital melanocytic nevi and the risk of melanoma

作者：Leite Viana Ana Carolina; Andrade Goulart Eugenio Marcos; Gontijo Bernardo; Bittencourt Flavia Vasques^*

来源：Anais Brasileiros de Dermatologia, 2017, 92(2): 199-204.

DOI：10.1590/abd1806-4841.20175176

• Melanoma
• Nevus
• pigmented
• Nevi and melanomas
• Risk

Background: Large congenital melanocytic nevus (LCMN) is considered a risk factor for melanoma, although the magnitude of this risk is controversial.
Objective: To evaluate the risk of melanoma development in patients with LCMN seen at a dermatology referral center in Brazil during a twelve-year period. To the best of our knowledge, there are no published similar studies on large congenital melanocytic nevus in South America.
Methods: Our prospective cohort included only patients with congenital nevi >= 20cm. The cumulative risk of developing melanoma and the standardized morbidity ratio were calculated for patients followed up prospectively for at least 1 month.
Results: Sixty-three patients were enrolled in this study. One patient who developed melanoma prior to enrollment was excluded, and five were eliminated because of insufficient follow-up time. Mean follow-up for the remaining 57 patients was 5.5 years (median 5.2 years). Median age of entry into the study was 2.6 years. Most patients (75.4%) underwent only clinical observation. Melanomas occurred in 2 (3.5%) patients. Five-year cumulative risk for melanoma was 4.8% (95% CI: 1.9-11.5%). Standardized morbidity ratio was 1584 (95% CI: 266-5232, p<0.001).
Study limitations: The small sample size reduces the accuracy of risk estimates.
Conclusions: This study analyzed prospectively for the first time data from South America demonstrating that patients with LCMN have a higher risk of developing melanoma than the general population (p<0.001).

• 出版日期2017-4