title: Dermoscopic changes in melanocytic nevi in patients receiving immunosuppressive and biologic treatments: results of a prospective case-control study.
abstract: BACKGROUND
  The immune system restrains benign melanocytic lesions, however the relationship between immunosuppression and changes in nevi is not known.
  
  
  OBJECTIVE
  We sought to investigate the development of new nevi in patients using immunosuppressive agents, to evaluate any size or dermoscopic changes in existent nevi, and to evaluate any risk of developing melanoma.
  
  
  METHODS
  There were 266 melanocytic lesions in 103 patients undergoing immunosuppressive therapy and 180 melanocytic lesions matched for age, sex, race, and Fitzpatrick skin type in 60 healthy control subjects.
  
  
  RESULTS
  Nevus counts increased from baseline in the treatment group (P < .001) as did nevus size (P = .046) but the increase compared with the control group only remained statistically significant for nevus numbers (P = .001). There was a statistically significant appearance of dermoscopic changes in the nevi of immunosuppressed patients compared with healthy control subjects (P < .001). Ten lesions were excised including 6 because of significant dermoscopic change during treatment and all were benign.
  
  
  CONCLUSIONS
  Follow-up duration was short and the number of patients was small.
  
  
  CONCLUSIONS
  Immunosuppressive therapy was associated with increased nevus counts and changed dermoscopic appearance but as none of the changed and subsequently excised nevi were malignant, continued monitoring for invasive features is a reasonable alternative to excision.
authors: Department of Dermatology at Ankara University Faculty of Medicine, Ankara, Turkey. Electronic address: drgamzealkiz@gmail.com.
authors: Gamze
authors: G
authors: Koseoglu
authors: Department of Dermatology at Ankara University Faculty of Medicine, Ankara, Turkey.
authors: Bengu Nisa
authors: BN
authors: Akay
authors: Department of Internal Medicine-Rheumatology, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey.
authors: Orhan
authors: O
authors: Kucuksahin
authors: Department of Dermatology at Ankara University Faculty of Medicine, Ankara, Turkey.
authors: Cengizhan
authors: C
authors: Erdem
mesh_terms: D000328:Adult; D001688:Biological Products / Q000008:administration & dosage* / Q000009:adverse effects; D001707:Biopsy, Needle; D016022:Case-Control Studies; D046169:Dermoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000188:drug therapy* / Q000473:pathology*; D011446:Prospective Studies; D012016:Reference Values; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001688:Biological Products; D007166:Immunosuppressive Agents
keywords: anti–tumor necrosis factor-alfa; azathioprine; cyclosporine; dermoscopy; immunosuppression; immunosuppressive treatment; melanocytic nevus; melanoma; methotrexate