Growth-curve modeling of nevi with a peripheral globular pattern Journal Article

Authors: Bajaj, S.; Dusza, S. W.; Marchetti, M. A.; Wu, X.; Fonseca, M.; Kose, K.; Brito, J.; Carrera, C.; Martins, De, Silva, V. P.; Malvehy, J.; Puig, S.; Yagerman, S.; Liebman, T. N.; Scope, A.; Halpern, A. C.; Marghoob, A. A.
Article Title: Growth-curve modeling of nevi with a peripheral globular pattern
Abstract: IMPORTANCE Although nevi with a peripheral rim of globules (peripheral globular nevi [PGN]) observed with dermoscopy are associated with enlarging melanocytic nevi, their actual growth dynamics remain unknown. Because change is a sensitive but nonspecific marker for melanoma, beginning to understand the growth patterns of nevi may improve the ability of physicians to differentiate normal from abnormal growth and reduce unnecessary biopsies. OBJECTIVE To study the growth dynamics and morphologic evolution of PGN on dermoscopy. DESIGN, SETTING, AND PARTICIPANTS A total of 84 participants with 121 PGN from September 1, 1999, through May 1, 2013, were identified retrospectively. Cohorts were recruited from the Memorial Sloan Kettering Cancer Center; Melanoma Unit of the Hospital Clinic, University of Barcelona; and Study of Nevi in Children. All 3 cohorts underwent longitudinal monitoring with serial dermoscopic imaging of their PGN. Data analysis was performed from May 1, 2014 through April 1, 2015. MAIN OUTCOMES AND MEASURES Establishment of the natural growth curve of PGN. The secondary aim was to establish the median time to growth cessation in those PGN for which the size eventually stabilized and/or had begun to decrease during the study period. RESULTS The median duration of follow-up was 25.1 (range, 2.0-114.4) months. Most of the nevi (116 [95.9%]) enlarged at some point during sequential monitoring. The rate of increase in the surface area of PGN varied among cohorts and ranged from -0.47 to 2.26mm2/mo (mean rate, 0.25 [95%CI, 0.14-0.36]mm2/mo). The median time to growth cessation in the 26 PGN that stabilized or decreased in size (21.5%) was 58.6 months. All lesions changed in a symmetric manner and 91 (75.2%) displayed a decrease in the density of peripheral globules over time. CONCLUSIONS AND RELEVANCE Nevi displaying a peripheral globular pattern enlarged symmetrically with apparent growth cessation occurring during a span of 4 to 5 years. Our results reiterate the important concept that not all growth is associated with malignancy. Copyright 2015 American Medical Association. All rights reserved.
Keywords: adult; controlled study; human tissue; major clinical study; histopathology; cancer risk; follow up; cancer susceptibility; disease association; skin biopsy; nevus; cohort analysis; patient monitoring; retrospective study; epiluminescence microscopy; risk assessment; disease duration; cutaneous melanoma; pigmented nevus; growth curve; human; male; female; priority journal; article
Journal Title: JAMA Dermatology
Volume: 151
Issue: 12
ISSN: 2168-6068
Publisher: American Medical Association  
Date Published: 2015-12-01
Start Page: 1338
End Page: 1345
Language: English
DOI: 10.1001/jamadermatol.2015.2231
PROVIDER: scopus
PUBMED: 26287475
PMCID: PMC5483973
Notes: Article -- Export Date: 7 January 2016 -- 1338 -- Source: Scopus
Citation Impact
MSK Authors
  1. Allan C Halpern
    385 Halpern
  2. Stephen Dusza
    255 Dusza
  3. Alon Scope
    123 Scope
  4. Ashfaq A Marghoob
    507 Marghoob
  5. Tracey Nicole Liebman
    11 Liebman
  6. Kivanc Kose
    72 Kose
  7. Michael Armando Marchetti
    149 Marchetti
  8. Maira   Fonseca
    14 Fonseca
  9. Xinyuan   Wu
    9 Wu
  10. Shirin   Bajaj
    16 Bajaj