Changes in Melanocytic Nevi and Melanoma Associated With Pregnancy: A Scoping Review.

Abstract

Pregnancy is a transformative period characterized by numerous physiological and hormonal changes, including those affecting the skin. Among these changes, alterations in melanocytic nevi and the potential risk of melanoma are areas of significant interest and ambiguity. This scoping review aims to synthesize existing literature on these topics to provide a comprehensive understanding and identify gaps in knowledge. Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews guidelines, a systematic search was conducted; out of 4824 identified articles, 80 met the inclusion criteria. While some studies suggest hormonal influences might accelerate melanocyte growth, others argue that perceived growth is due to mechanical stretching of the skin, and still others found no significant size changes. Pigmentary changes in nevi are more consistently reported, though some researchers advocate viewing them with suspicion until proven benign. The risk of developing pregnancy-associated melanoma is contentious, with some studies proposing that hormonal changes and gestational immunosuppression increase susceptibility, but the evidence remains inconclusive. Prognostic outcomes are equally disputed, with conflicting findings on pregnancy-associated melanoma thickness, recurrence rates, and survival outcomes. We also performed a novel semi-quantitative analysis to assess attitudes on the risk and prognosis of pregnancy-associated melanoma in the literature, demonstrating that authors of narrative reviews are more likely to oppose theories of pregnancy as a trigger for melanoma development or progression than researchers who conducted the primary investigations. These inconsistencies in the literature highlight the need for further research with standardized methodologies and consideration of confounding factors.