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Heike Luther, MD; Peter Altmeyer, MD, PhD; Claus Garbe, MD, PhD; Ulf Ellwanger; Sabine Jahn, MD; Klaus Hoffmann, MD; Martin Segerling, MD, PhD

Arch Dermatol. 1996;132(12):1473-1478.

Abstract
Objectives
To investigate nevus development in childhood and to examine causative related factors such as pigment phenotype and the role of sun exposure in the development of melanocytic nevi.

Design and Participants
Nevus counts were performed in kindergarteners (n=866) before the age of 7 years and again 5 years later (n=377). Eligible for analysis were 357 children who were examined twice. Possible related factors were searched for by standardized interviews with parents.

Results
The mean number of nevi measuring 1 mm or more was 9 in the first examination and the number measuring 2 mm or more, 4. Five years later, the mean number of nevi measuring 1 mm or more was 40 and the number measuring 2 mm or more was 16. Children with poor sun tolerance had statistically significant more nevi (relative risk, 3.7; 95% confidence interval, 1.9-7.2). The presence of freckles was a strong predictor for a high increase of melanocytic nevi (relative risk, 2.1; 95% confidence interval, 1.3-3.3). The number of days per year with intensive solar exposure was an independent prognostic factor. The relative risk for the development of melanocytic nevi was increased by a factor of 1.6 in children who had more than 21 days of intensive sun exposure per year (95% confidence interval, 1.0-2.5).

Conclusion
The development of melanocytic nevi in childhood is strongly related to characteristics of pigmentation associated with poor sun tolerance. In addition, we found evidence for the influence of UV radiation on the number of acquired melanocytic nevi in childhood.

Arch Dermatol. 1996;132:1473-1478

Author Affiliations
From the Dermatological Department, Ruhr-University Bochum (Drs Luther, Altmeyer, Jahn, and Hoffmann), and the Local Health Service of Bochum (Dr Segerling), Bochum, Germany; and the Central Malignant Melanoma Registry, Department of Dermatology, Eberhard-Karls-University, Tübingen, Germany (Dr Garbe and Mr Ellwanger).

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