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Journal of the American Academy of Dermatology
Volume 74, n° 1
pages 88-93 (janvier 2016)
Doi : 10.1016/j.jaad.2015.09.028
accepted : 12 September 2015
Original Articles

A comparative study of proliferative activity and tumor stage of pregnancy-associated melanoma (PAM) and non-PAM in gestational age women

Emily A. Merkel, BA a, Mary C. Martini, MD a, Sapna M. Amin, MD a, Oriol Yélamos, MD a, Christina Y. Lee, BA a, Lauren M. Sholl, MS a, Alfred W. Rademaker, PhD b, Joan Guitart, MD a, Pedram Gerami, MD a,
a Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 
b Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 

Reprint requests: Pedram Gerami, MD, Department of Dermatology, Northwestern University, 676 N St Clair St, Suite 1765, Chicago, IL 60611.

The influence of pregnancy on the development, progression, and prognosis of melanoma is controversial.


We sought to compare clinical characteristics, histologic features, and proliferative activity in pregnancy-associated melanoma (PAM) and melanoma in nonpregnant women of reproductive age (non-PAM).


In this retrospective cohort study, we reviewed medical records and pathology reports from women given a diagnosis of melanoma between 2006 and 2015. We also examined tumor proliferation rates using mitotic count and 2 immunohistochemical markers of proliferation, phosphohistone H3 and Ki-67.


In 50 PAM and 122 non-PAM cases, a diagnosis of melanoma in situ was associated with PAM. Among invasive melanomas, there was no difference in proliferative activity between groups. Pregnancy status was also not associated with age at diagnosis, tumor site, Breslow depth, Clark level, ulceration, or overall stage.


This was a retrospective study with a small sample size of mostly patients with early-stage melanoma.


In our study of primarily early-stage melanoma, pregnancy did not have a significant impact on tumor proliferation. Particularly for patients given a diagnosis of stage I melanoma who are undergoing close surveillance, a history of PAM should not outweigh traditional factors, such as advanced maternal age, in planning future pregnancies.

The full text of this article is available in PDF format.

Key words : immunohistochemistry, Ki-67, malignant melanoma, mitotic rate, phosphohistone H3, pregnancy

Abbreviations used : AJCC, EGA, PAM, pHH3

 Supported by the IDP Foundation.
 Disclosure: Dr Martini has served on the advisory board of Dove-Unilever, receiving honoraria. Dr Rademaker has served on the advisory board of Georgetown University Cancer Center, as an instructor for the American Association of Cancer Research, and as a consultant for the National Institutes of Health and Journal of the American Medical Association , receiving honoraria. Dr Gerami has served as a consultant to Castle Biosciences Inc, Myriad Genetics, and DermTech Inc, receiving honoraria. Ms Merkel; Drs Amin, Yélamos, and Guitart; Ms Lee; and Ms Sholl have no conflicts of interest to declare.

© 2015  American Academy of Dermatology, Inc.@@#104156@@