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Patients with melanoma commonly display few nevi, no atypical nevi

Most patients with melanoma commonly had few nevi and no atypical nevi, according to recent study results.

“Several novel public health messages emerge from our study, including that melanomas are more commonly diagnosed in individuals with fewer nevi compared with those with a high mole count,” Alan C. Geller, MPH, RN, from the department of social and behavioral sciences at Harvard T. H. Chan School of Public Health in Boston, and colleagues wrote. “Therefore, physicians and patients should not rely on the total nevus count as a sole reason to perform skin examinations or to determine a patient’s at-risk status.”

Geller and colleagues evaluated the total nevi and atypical nevi (AN) counts of 566 patients (39% female; mean age, 56.7 years) with melanoma at two academic centers and one Veteran Affairs hospital between May 2006 and March 2009, according to the abstract. Total nevi counts were categorized as 0 to 20, 20 to 50 or more than 50, while atypical nevi counts were categorized as zero, one to five or more than five and tumor thickness was categorized as 2 mm or less, or 2.01 mm or greater.

The researchers found 376 patients (66.4%) had zero to 20 total nevi, 116 patients (20.5%) had 20 to 50 total nevi and 74 patients (13.1%) had more than 50 total nevi. Of the patients, 415 patients (73.3%) had zero atypical nevi, 82 patients had one to five atypical nevi and 69 patients had more than five atypical nevi.

There was a reduced risk of thick melanoma for patients younger than 60 years old who had more than 50 total nevi (OR = 0.32; 95% CI, 0.12-0.81). However, Geller and colleagues noted patients with more than five atypical nevi had an increased risk of thicker melanoma compared with patients who have no atypical nevi (OR = 2.43; 95% CI, 1.02-5.75). – by Jeff Craven

Disclosure: Sober reported owning stock in Merck & Co., Amgen, Teva and Pfizer.