Biomedical subjects

Caroline Bevona

Publications and source records attributed to Caroline Bevona.

5 recordsLinked to original sources

PubMed2004

Prolonged evolution of a lentigo maligna.

Lentigo maligna (LM) is a melanocytic lesion which is a potential precursor to melanoma and often has a prolonged intraepidermal growth phase before evolving into lentigo maligna melanoma (LMM). LM is also noted for its tendency to locally recur after treatment. We present a patient who had a persistent LM on her left cheek which, despite multiple excisions, persisted and transformed into a partially amelanotic LMM roughly three decades later. Our patient's course was also notable for this melanoma recurring at the edge of, and subsequently migrating into, a previously placed skin graft.

Aged↗

PubMed2003

Cutaneous melanomas associated with nevi.

OBJECTIVE: To determine the frequency of and the histologic and clinical factors associated with melanoma existing in histologic contiguity with a nevus. DESIGN: Pathology reports from melanomas collected from January 1, 1993, to December 31, 1997, were retrospectively reviewed. SETTING: Independent, community-based dermatopathology laboratory. PATIENTS: A total of 1606 patients with a histologic diagnosis of melanoma. INTERVENTION: None. MAIN OUTCOME MEASURES: Differences in histologic (subtype, Breslow thickness, and Clark level) and clinical (age, sex, and anatomic location) features between melanomas that are associated and unassociated with a nevus. RESULTS: Twenty-six percent of the melanomas reviewed were histologically associated with nevi (dysplastic nevi, 43.0%; and other nevi, 57.0%). Factors that were significantly associated with an increased likelihood of a melanoma being histologically contiguous with a nevus included younger age, superficial spreading subtype, truncal location, Breslow thickness, and Clark level. However, after multivariate analysis, only younger age (odds ratio, 1.27; 95% confidence interval, 1.19-1.37), superficial spreading subtype (odds ratio, 2.96; 95% confidence interval, 2.17-4.02), and truncal location (odds ratio, 3.26; 95% confidence interval, 2.55-4.19) remained significant. CONCLUSIONS: Most melanomas were not histologically contiguous with a nevus. Younger age, superficial spreading subtype, and truncal location are independent significant predicators of a melanoma being histologically associated with a nevus.

Adolescent↗

PubMed2003

The transformation rate of moles (melanocytic nevi) into cutaneous melanoma: a population-based estimate.

BACKGROUND: Moles, or melanocytic nevi, are both markers of an increased risk of cutaneous melanoma and direct precursor lesions. Recent strategies to reduce the burden of advanced disease have focused on early detection and ongoing surveillance of moles for malignant degeneration. Inherent in this approach is the notion that moles exhibit a certain risk of transformation into melanoma; however, this risk is unknown. OBJECTIVE: To estimate the risk of moles transforming into cutaneous melanoma. DESIGN: We first constructed a model of transformation based on the assumption that the minimal number of moles turning into cutaneous melanoma per year is roughly equivalent to the number of melanomas diagnosed each year with associated nevic components. The annual risk was then calculated as the number of mole-associated melanomas diagnosed in 1 year (stratified by 10-year age groups) divided by the number of moles in a the same 10-year age group. We also estimated the cumulative risk during the lifetime of an individual mole by using a modification of the standard life table method. RESULTS: The annual transformation rate of any single mole into melanoma ranges from 0.0005% or less (ie, </=1 in 200,000) for both men and women younger than 40 years to 0.003% (about 1 in 33,000) for men older than 60 years. The rate is similar between men and women younger than 40 years but becomes substantially higher for men older than 40 years. For a 20-year-old individual, the lifetime risk of any selected mole transforming into melanoma by age 80 years is approximately 0.03% (1 in 3,164) for men and 0.009% (1 in 10,800) for women. CONCLUSIONS: The risk of any particular mole becoming melanoma is low, especially in younger individuals. However, since moles can disappear, ones that persist into old age have an increased risk of malignant degeneration. For young people with innumerable moles and no other associated risk factors, systematic excision of benign-appearing lesions would be of limited benefit.

Adult↗

PubMed2003

Dermal melanocytic proliferation with features of a plaque-type blue nevus and neurocristic hamartoma.

Blue nevi (BN) and neurocristic hamartomas (NCH) are pigmented lesions that originate from the aberrant development of cells derived from the neural crest. BN are composed of dermal melanocytes, whereas NCH have a broader histology and show Schwann cell differentiation as well. In addition, BN and NCH might differ in their potential to develop into a malignancy. We describe a patient with a lesion showing features of both a plaque-type BN and NCH.

Adult↗

PubMed2002

Melanoma incidence trends.

This article describes melanoma as an important health concern because of its rapid and continuous growth in many parts of the world. In the United States, a persistent increase in incidence is seen, which has started to slow in recent years. In some countries, differing trends are seen in younger people, with incidence and mortality rates leveling off or decreasing in this population. This article describes that despite this leveling off, melanoma incidence is likely to continue to rise in the near future, because rates are still increasing in older people who comprise most of those afflicted with melanoma.

Adolescent↗