The Natural Evolution of Nevi with Peripheral Globules

Paula Anca Ilut; Elisa Camela; Konstantinos Lallas; Chryssoula Papageorgiou; Sofia-Magdalini Manoli; Athanassios Kyrgidis; Konstantinos Liopyris; Dimitrios Sgouros; Zoe Apalla; Aimilios Lallas

doi:10.1159/000531004

The Natural Evolution of Nevi with Peripheral Globules

Dermatology. 2023;239(5):760-767. doi: 10.1159/000531004. Epub 2023 Jun 6.

Authors

Affiliations

¹ Department of Dermatology, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
² Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
³ Department of Medical Oncology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece.
⁴ Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece.
⁵ First Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece.
⁶ Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, General Hospital of Thessaloniki "George Papanikolaou,", Thessaloniki, Greece.
⁷ Department of Dermatology, University of Athens, Andreas Sygros Hospital for Cutaneous and Venereal Diseases, Athens, Greece.
⁸ Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
⁹ Second Department of Dermatology and Venereology, ATTIKON General University Hospital, Medical School, National and Kapodistrian University, Athens, Greece.

PMID: 37279706
DOI: 10.1159/000531004

Abstract

Background: Peripheral globules (PG) in melanocytic lesions represent a concerning dermoscopic feature since they might be present in growing nevi and melanomas. Their natural evolution has not been fully elucidated, and an age-based management approach has been recommended.

Objectives: The aim of this study was to calculate the growth rate of lesions with PG and investigate possible association with age, sex, location, and the global dermoscopic pattern.

Methods: We retrospectively selected the lesions of interest from a cohort of Caucasian patients who underwent sequential digital dermoscopy monitoring. Lesions with PG distributed at 75% or more of their circumference with available follow-up images or histopathologic report were included. The surface area was automatically calculated with the help of an incorporated tool used in the acquisition of the images. The images were also evaluated by independent investigators for the presence of pre-defined criteria. Growth-curve models were used to assess the growth rate. The outcome variable was the area of nevi in mm2, and scatterplots with Lowess curves were used to present the mean change of nevi during follow-up.

Results: A total of 208 lesions from 98 patients with a median age of 36 years (range 15-75) were included. The median follow-up time was 18 months (range 4-48). The mean growth rate for all nevi was 0.16 mm2/month (95% CI, 0.14-0.18, p < 0.001), ranging from -0.29 to 0.61 mm2/month. The growth rate was higher in nevi with a homogeneous dermoscopic pattern (p < 0.001). The number of peripheral globules during follow-up varied from increasing to complete disappearance. None of the lesions developed any melanoma-specific structure at follow-up.

Conclusion: Nevi with PG grew at a mean rate of 0.16 mm2/month, and the growth rate was independent of age, gender, or anatomic location. Nevi with homogeneous pattern demonstrated the highest growth rate in our cohort. None of the monitored nevi with PG developed melanoma-specific criteria at follow-up.

Keywords: Growth curve; Nevus life cycle; Peripheral globule nevi.

MeSH terms

Adolescent
Adult
Aged
Dermoscopy / methods
Humans
Melanoma* / pathology
Middle Aged
Nevus*
Nevus, Pigmented* / pathology
Retrospective Studies
Skin Neoplasms* / pathology
Syndrome
Young Adult