Cutaneous tumors in pregnancy.
Pregnancy alters the frequency and natural course of certain skin tumors. Pregnancy-associated changes in melanocytic nevi are transient, and there is no substantiated evidence of increased risk of malignant transformation of melanocytic nevi in gestation. Characteristic vascular and pigment-related dermatoscopic features are helpful in evaluating pigmented lesions, but a biopsy should be performed for significant change or other worrisome features in a lesion. Outcomes for pregnancy-associated melanoma do not appear to be poorer compared with nonpregnancy melanoma; however, data are limited for advanced (stage III/IV) melanoma. Some studies suggest increased propensity for lymphovascular spread, but more data are needed for definitive conclusions and guidelines on prognostication, workup, and treatment of pregnancy-associated melanoma. Vascular tumors, particularly pyogenic granuloma (granuloma gravidarum), occur with increased frequency and are associated with pro-angiogenic hormonal influences. Dermatofibrosarcoma protuberans has a more aggressive course during pregnancy with both prompt surgical treatment and close monitoring for recurrence being indicated.
Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Electronic address: Joanna_walker@brown.edu.
Joanna L
JL
Walker
Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Annie R
AR
Wang
Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
George
G
Kroumpouzos
Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Division of Dermatology, Veterans Affairs Medical Center, Providence, Rhode Island.
Martin A
MA
Weinstock
D000796:Angiolymphoid Hyperplasia with Eosinophilia / Q000209:etiology; D002277:Carcinoma / Q000473:pathology*; D018223:Dermatofibrosarcoma / Q000601:surgery*; D005260:Female; D017789:Granuloma, Pyogenic / Q000209:etiology; D006728:Hormones / Q000097:blood; D006801:Humans; D008207:Lymphatic Metastasis; D008545:Melanoma / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D009367:Neoplasm Staging; D009508:Nevus, Pigmented / Q000473:pathology*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology* / Q000628:therapy*; D012514:Sarcoma, Kaposi / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology* / Q000628:therapy*
D006728:Hormones