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Perianal area examination may aid in identifying atypical nevi during melanoma screening
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Patients undergoing melanoma screening and surveillance should also undergo a screening of the perianal area for melanocytic nevi, which were associated with atypical nevi on other areas of the body, according to recent data published in JAMA Dermatology.
“The perianal area is difficult to self-examine and may harbor a malignant tumor, including [cutaneous melanoma],” Ava Socik, BA, from Rush Medical College at Rush University in Chicago, Illinois, and colleagues wrote. “Given the high prevalence of perianal nevi in our study patients, many of whom are known to be at high risk for developing [cutaneous melanoma], one may conclude that the perianal area should not be ignored during [cutaneous melanoma] screening and surveillance.”
Socik and colleagues analyzed 236 non-Hispanic white (n=219), Hispanic white (n=4) and nonwhite (n=13) patients who underwent evaluation for melanoma or skin cancer by a single dermatologist between Nov. 25, 2013, and Oct. 16, 2014. The patients were aged 23 to 84 years and included 138 men and 98 women.
The researchers found that 48.9% of non-Hispanic whites had perianal nevi of any size. In addition, 39.7% had perianal nevi at least 2 mm in diameter and 5.5% had perianal nevi 5 mm or larger. Among Hispanic white patients, 50% had perianal nevi of any size, but none had nevi 2 mm in diameter or higher. Of the nonwhite patients who had perianal nevi of any size (38.5%) all had nevi 2 mm in diameter or higher; none had nevi greater than 5 mm.
There was a significant association between one perianal nevus and a history of atypical nevus excision (OR = 2.9; 95% CI, 1.5-5.7) among non-Hispanic whites. Other factors associated with one perianal nevus included one extant atypical nevus (OR = 2.2; 95% CI, 1.3–3.9); atypical nevus pattern (OR = 2; 95% CI, 1.2-3.6); 20 or more nevi at least 2 mm in diameter, with at least five nevi at least 5 mm (OR = 1.8; 95% CI, 1.1–3.1); and a minimum of four atypical nevi at least 5 mm in diameter (OR = 1.9; 95% CI, 1.1 – 3.3). – by Jeff Craven
Disclosure: Rhodes reports serving as a consultant for Castle Bioscience.
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