Melanoma and melanocytic nevi in pregnancy

A changing melanocytic nevus during pregnancy should be biopsied promptly. For women with the dysplastic nevus syndrome, there may be more changes in nevi during pregnancy, requiring close monitoring. Melanoma is one of the most common malignancies that occurs during pregnancy. Those diagnosed with a localized melanoma before, during, or after pregnancy do not have an altered prognosis; however, a few studies have noted thicker melanomas and poorer prognosis when melanoma is diagnosed in the first year postpartum, possibly due to a delay in diagnosis. Although local excision of melanomas can be performed safely during pregnancy, sentinel lymph node biopsy during pregnancy is controversial for the timing and method. There are safe methods of imaging with some special precautions for staging in pregnant women. Systemic therapy requires an interdisciplinary team to assist in patient decision-making because some of these agents are teratogenic. There is no reason to withhold combined estrogen-progestin oral contraceptives or menopausal hormone therapy in those with a previous diagnosis of melanoma, nor should future pregnancies be delayed in those diagnosed with localized melanoma. Only limited data are available concerning prognosis for women with a melanoma diagnosis after in vitro fertilization.