Introduction: Melanoma accounts for around 1% of all skin tumors yet is responsible for 80%
of deaths related to skin cancer. Although adjuvant therapies improve survival, their effects on nevi
remain unclear.
Objectives: This study aimed to investigate the dermoscopic and histopathological features of mela-
nocytic nevi in melanoma patients receiving adjuvant systemic therapy.
Methods: Dermoscopic images of 1,299 melanocytic nevi from 25 melanoma patients undergoing
adjuvant therapy (targeted therapy, immunotherapy, or IFN-α) were analyzed before and after treat-
ment. The histopathological features of 129 excised nevi from 67 melanoma patients were compared
between patients who received adjuvant therapy and those who did not.
Results: Melanoma patients on targeted therapy showed a greater reduction in global pigmentation
and disappearance of the pigment network than those on IFN-α and immunotherapy (p=0.001 and
P=0.017, respectively). IFN-α therapy was associated with more atypical pigment network changes
than targeted therapy and immunotherapy (P=0.027). Histopathologically, structural atypia, cytolog-
ical atypia, inflammation, and fibroplasia were more prevalent in excised nevi from patients receiving
adjuvant therapy (P=0.003, P=0.004, P<0.001, P=0.020, respectively).
Conclusions: Adjuvant systemic therapy induces dermoscopic and histopathological changes in
melanocytic nevi. Clinicians and pathologists should carefully consider these alterations during mela-
noma follow-up to inform treatment decisions.
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