Melanoma risk stratification of individuals with a high‐risk naevus phenotype – A pilot study. (2nd April 2019) - Rishpon, Ayelet
Abstract: Background/Objectives: High a naevus counts and atypical naevi are risk factors for cutaneous melanoma. However, many individuals with a high‐risk naevus phenotype do not develop melanoma. In this study, we describe the clinical and dermoscopic attributes of naevi associated with melanoma in a high‐risk naevus phenotype population. Methods: This single‐centre, hospital‐based case–control study included 54 prospectively enrolled adult patients ≥18 years old with a high‐risk naevus phenotype (18 cases with a history of melanoma and 36 age‐ and gender‐matched controls without a history of melanoma). We analysed clinical and dermoscopic images of the 20 largest naevi for each participant. Results: Cases had a higher mean age than controls (48.2 vs. 39.1 years, P = 0.007) but there was no difference in the male‐to‐female ratio between groups. Nearly, all participants (97%) were Fitzpatrick skin type II or III. Naevi in cases were more likely to be truncal, (72.6% vs. 53.6%, P = 0.01), particularly anterior truncal, (29.2% vs. 14.4%, P < 0.001) and larger than 8 mm (17.4% vs. 7.8%%, P = 0.01) compared to controls. CASH score of naevi did not differ between groups. Naevi in cases were more likely to have a multicomponent dermoscopic pattern than in controls (18.4% vs. 12.6%, P = 0.02). Conclusion: Larger naevi, truncal naevi, and naevi, with a multicomponent dermoscopic pattern may be risk factors for melanoma among individuals with a high‐risk naevus phenotype. Further studies are needed to validate these findings.