Pregnancy and estrogen receptor beta expression in a large congenital nevus.

BACKGROUND Large congenital nevi carry a slightly increased risk of melanoma. Pregnancy poses an additional challenge in the monitoring of these patients because little is known regarding the effects of increased estrogen levels on congenital nevi. OBSERVATIONS A young woman was observed to have clinical lightening of her garment nevus and satellite nevi during 2 sequential pregnancies. Postpartum, the patient experienced darkening and repigmentation in her large garment nevus, with continued lightening of nearby satellite lesions. In addition to photographic documentation of these changes, biopsy samples taken during pregnant and nonpregnant periods underwent immunohistochemical evaluation for estrogen receptor beta (ERbeta), the predominant estrogen receptor in nevi and melanomas. Biopsy samples collected during pregnancy showed a decrease in nuclear staining for ERbeta compared with samples collected after pregnancy. These changes in ERbeta expression were not associated with histologic atypia during pregnancy or after delivery. CONCLUSIONS Congenital nevi may be unique in their response to altered estrogen levels. Given the slightly increased risk of melanoma in giant congenital nevi and the dearth of information available regarding the effects of pregnancy on congenital nevi, this case illustrates the need for further study of these pigmented lesions.

[1]  L. Nanney,et al.  Estrogen receptor β expression in nevi during pregnancy , 2008, Experimental dermatology.

[2]  K. Dahlman-Wright,et al.  Review Nuclear Receptor Signaling | The Open Access Journal of the Nuclear Receptor Signaling Atlas Estrogen receptor β: an overview and update , 2022 .

[3]  J. Grant-Kels,et al.  Hormones, nevi, and melanoma: an approach to the patient. , 2007, Journal of the American Academy of Dermatology.

[4]  L. Nanney,et al.  Oestrogen receptor‐β expression in melanocytic lesions , 2006 .

[5]  J. Grant-Kels,et al.  Nevi and melanoma in pregnancy. , 2006, Dermatologic clinics.

[6]  P. G. Lang,et al.  Large or Multiple Congenital Melanocytic Nevi: Occurrence of Cutaneous Melanoma in 1008 Persons , 2006 .

[7]  Weimin Hu,et al.  Malignant Melanoma Arising in a Pregnant African American Woman with a Congenital Blue Nevus , 2004, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[8]  M. Mihm,et al.  A nonepidermal, primary malignant melanoma arising in a giant congenital melanocytic nevus 40 years after partial surgical removal. , 2004, Journal of the American Academy of Dermatology.

[9]  Z. Abdel‐Malek,et al.  Regulation of the human melanocortin 1 receptor expression in epidermal melanocytes by paracrine and endocrine factors and by ultraviolet radiation. , 2002, Pigment cell research.

[10]  C. Grin,et al.  Does pregnancy alter melanocytic nevi? , 2001, Journal of cutaneous pathology.

[11]  S. Loitsch,et al.  Quantification of tyrosinase, TRP-1, and Trp-2 transcripts in human melanocytes by reverse transcriptase-competitive multiplex PCR--regulation by steroid hormones. , 1998, The Journal of investigative dermatology.

[12]  C. Tomasini,et al.  Agminated Spitz nevi occurring within a congenital speckled lentiginous nevus. , 1995, The American Journal of dermatopathology.

[13]  A. Swerdlow,et al.  The risk of melanoma in patients with congenital nevi: a cohort study. , 1995, Journal of the American Academy of Dermatology.

[14]  S. Ubertalli,et al.  [Congenital giant melanocytic mole and pregnancy. Report of a case and review of the literature]. , 1990, Minerva ginecologica.

[15]  D. Ellis,et al.  Estrogen and progesterone receptors in congenital melanocytic nevi. , 1985, Journal of the American Academy of Dermatology.