Hormones, nevi, and melanoma: An approach to the patient

      For many years, clinicians have been concerned about a potential adverse effect of pregnancy-associated hormones and exogenous hormones on melanocytic nevi and malignant melanoma. Today, these issues are more significant as women have delayed childbearing into their 30's and 40's, and the likelihood of diagnosis with melanoma during pregnancy is enhanced. More recent clinical, epidemiologic, and laboratory studies have shed some light on the relationship among hormones, nevi, and melanoma in pregnancy.

      Learning objectives

      In this review, we hope to provide the clinician with the most recent information to help them address (1) changes in nevi during pregnancy; (2) the influence on the prognosis for women diagnosed with melanoma before, during, or after pregnancy; (3) the characteristics of melanomas diagnosed during pregnancy; (4) the evaluation and treatment of the woman diagnosed with melanoma during pregnancy; and (5) counseling of women diagnosed with melanoma during the childbearing years concerning future pregnancy, oral contraceptive pills, and hormone replacement therapy. In addition, we will evaluate clinical and/or laboratory evidence regarding a relationship between hormones and melanocytic nevi or melanoma.

      Abbreviations used:

      AJCC (American Joint Committee on Cancer), CT (computed tomographic), DFI (disease-free interval), DNS (dysplastic nevus syndrome), ER (estrogen receptor), FDA (Food and Drug Administration), HRT (hormone replacement therapy), MM (malignant melanoma), MRI (magnetic resonance imaging), OCP (oral contraceptive pills), SLN (sentinel lymph node), TDS (total dermoscopic score)
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