Nevus Variations in the Jordanian Population: Effects of Age, Medical Conditions, Environment, Congenital, Inherited, and Genetic Factors

Figures & data

Table 1 Demographic and Clinical Characteristics of Included Samples

Variables	N = 231	%
Age groups (Years)
18–23	23	10
24–29	45	19.5
30–35	40	17.3
36–41	40	17.3
42–47	35	15.2
48–53	24	10.4
54–59	14	6.1
60–65	6	2.6
66–71	3	1.3
84–89	1	0.4
Sex
Male	35	15.2
Female	196	84.8
Medical history
Normal patient	191	82.7
Diabetes Mellitus	6	2.6
Hypertension	12	5.2
Lung disease	2	0.9
Neurological disease	1	0.4
GIT disease	1	0.4
Cardiovascular disease	2	0.9
Tumors	2	0.9
Endocrine disease	7	3
Autoimmune disease	2	0.9
Hyperlipidemia	1	0.4
Two or more diseases	4	1.7
Surgical history
Minor procedure	5	2.2
Major procedure	1	0.4
Major with general anesthesia	65	28.1
Major with local anesthesia	2	0.9
Injection aesthetic	1	0.4
No previous surgeries	157	68
Drug History
Drugs for chronic disease	33	14.3
Drugs for infections	2	0.9
Oral contraceptive pills	1	0.4
Drugs for analgesia and pain killers	1	0.4
No drugs intake	190	82.6
Drugs for gastrointestinal disease	2	0.9
Drugs for cardiovascular	1	0.4
Drugs for multi-diseases	1	0.4

Table 2 Gross Nevi Characteristics of Included Samples

Variables	N = 231	%
Site of nevi^a
Face	136	58.9
Neck	27	11.7
Trunk	18	7.8
Back	9	3.9
Head	2	0.9
Scalp	5	2.2
Arms	6	2.6
Legs	4	1.7
Ear	2	0.9
Thigh	2	0.9
Distribution of nevi
Upper third of the face	20	8.7
Middle third of the face	76	32.9
Lower third of the face	54	23.4
Neck	26	11.3
Chest	2	0.9
Back	9	3.9
Shoulders	5	2.2
Right upper arm	2	0.9
Left thigh	1	0.4
Right lower leg	1	0.4
Left lower leg	1	0.4
Sole	1	0.4
Abdomen	8	3.5
Underarm	2	0.9
Back of the scalp	3	1.3
Multi distribution	20	8.7
Number of nevi
Less than 3	140	60.6
3–10	43	18.6
More than 10	48	20.8
Color of the nevus
Black	11	4.8
Brown	215	93.1
Pink	3	1.3
Others	2	0.9
Observed changes in the nevus^b
No observed changes	97	42
Ulceration	1	0.4
Bleeding	2	0.9
Change in size	22	9.5
Configuration	11	4.8
Change in color	11	4.8
Multiple changes	84	36.4

Notes: ^aN=211, ^bN=228.

Table 3 Microscopic Characteristics

Histopathological Findings	N=228	%
Intradermal melanocytic nevus Polypoidal intradermal melanocytic nevus, blue nevus	193	83.5
Seborrheic keratosis	15	6.5
Squamous papilloma	3	1.3
Basal cell carcinoma	1	0.4
Fibroepithelial polyp	3	1.3
Compound junctional melanocytic nevus, Lentigo simplex	9	3.9
Skin with focal dermal inflammation Small inclusion cyst with surrounding fibrosis and mild inflammation	2	0.9
Features reminiscent of Acrokeratosis of Hopf	1	0.4
Skin with acanthomatous change, melanin incontinence, hyperkeratosis with acanthosis	1	0.4

Table 4 Demographic, Clinical, and Histopathological Characteristics Associated with Nevi Changes

Variable	No changes, N = 97^a	Positive, N = 134^a	p-value^b
Age
18–23	9 (9.3%)	14 (10%)
24–29	22 (23%)	23 (17%)
30–35	16 (16%)	24 (18%)
36–41	14 (14%)	26 (19%)
42–47	19 (20%)	16 (12%)
48–53	12 (12%)	12 (9.0%)
54–59	3 (3.1%)	11 (8.2%)
60–65	2 (2.1%)	4 (3.0%)
66–71	0 (0%)	3 (2.2%)
84–89	0 (0%)	1 (0.7%)
Sex			0.4
Female	80 (82%)	116 (87%)
Male	17 (18%)	18 (13%)
Detailed Medical History			0.4
Autoimmune Diseases	0 (0%)	2 (1.5%)
Cardiovascular Diseases	1 (1.0%)	1 (0.7%)
DM	3 (3.1%)	3 (2.2%)
DM + HTN	0 (0%)	3 (2.2%)
Endocrine Diseases	1 (1.0%)	6 (4.5%)
GIT Diseases	0 (0%)	1 (0.7%)
HLD	0 (0%)	1 (0.7%)
HTN	4 (4.1%)	8 (6.0%)
HTN + Renal Dysfunction	0 (0%)	1 (0.7%)
Lung Diseases	0 (0%)	2 (1.5%)
Negative	88 (91%)	103 (77%)
Neurological Diseases	0 (0%)	1 (0.7%)
Tumors	0 (0%)	2 (1.5%)
Medical History			0.006
Negative	88 (91%)	103 (77%)
Positive	9 (9.3%)	31 (23%)
Surgical History			0.2
Injection aesthetic	1 (1.0%)	0 (0%)
Major Procedures	1 (1.0%)	0 (0%)
Major with general anesthesia	27 (28%)	38 (28%)
Major with local anesthesia	1 (1.0%)	1 (0.7%)
Minor Procedures	0 (0%)	5 (3.7%)
No previous surgeries	67 (69%)	90 (67%)
Drug History			0.3
Drugs for cardiovascular	1 (1.0%)	0 (0%)
Drugs for chronic disease	10 (10%)	23 (17%)
Drugs for chronic disease + Supplements	0 (0%)	1 (0.7%)
Drugs for GI disease	0 (0%)	2 (1.5%)
Drugs for infections	1 (1.0%)	1 (0.7%)
No drugs intake	85 (88%)	105 (78%)
Oral contraceptive pills	0 (0%)	1 (0.7%)
Pain killers	0 (0%)	1 (0.7%)
Number of Nevi			<0.001
<3	74 (76%)	66 (49%)
>10	13 (13%)	35 (26%)
3–10	10 (10%)	33 (25%)
Distribution of nevi			>0.9
Abdomen	3 (3.1%)	5 (3.7%)
Back	3 (3.1%)	6 (4.5%)
Chest	1 (1.0%)	1 (0.7%)
Left lower leg	0 (0%)	1 (0.7%)
Lower third of the face	23 (24%)	31 (23%)
Middle third of the face	34 (35%)	42 (31%)
Multiple sites	9 (9.3%)	13 (9.7%)
Neck	14 (14%)	12 (9.0%)
Right lower leg	0 (0%)	1 (0.7%)
Right upper arm	0 (0%)	2 (1.5%)
Scalp	1 (1.0%)	1 (0.7%)
Shoulders	1 (1.0%)	4 (3.0%)
Sole	0 (0%)	1 (0.7%)
Underarm	1 (1.0%)	1 (0.7%)
Upper third of the face	7 (7.2%)	13 (9.7%)
Color of the nevus			0.5
Black	4 (4.1%)	7 (5.2%)
Brown	90 (93%)	125 (93%)
Others	2 (2.1%)	0 (0%)
Pink	1 (1.0%)	2 (1.5%)
Histopathology Findings			0.3
Acrokeratosis of Hopf	0 (0%)	1 (0.7%)
Basal cell carcinoma	0 (0%)	1 (0.7%)
Fibroepithelial polyp	3 (3.2%)	0 (0%)
Hyperkeratosis with acanthosis	0 (0%)	1 (0.7%)
Lentigo simplex	4 (4.3%)	5 (3.7%)
Polypoidal intradermal melanocytic blue nevi	82 (87%)	111 (83%)
Seborrheic keratosis	4 (4.3%)	11 (8.2%)
Small inclusion cyst with fibrosis and inflammation	0 (0%)	2 (1.5%)
Squamous papilloma	1 (1.1%)	2 (1.5%)

Notes: ^an (%). ^bPearson’s chi-squared test; Fisher’s exact test.

Figure 1 Bar plots illustrating the distribution of the observed nevi changes in the included samples based on (A) Bar charts showing the distribution of nevi changes across patients with positive medical history compared to patients with negative medical history. Positive medical history showed a significantly higher proportion of multiple nevi changes while negative medical history was significantly associated with no nevi changes. (B) Bar charts showing the distribution of nevi changes and number of nevi, patients with multiple nevi changes had a significantly higher number of nevi >10, while patients with no nevi changes had less than three nevi.

Table 5 Demographic, Clinical, and Histopathological Characteristics Associated with Patients with Positive versus Negative Medical History

Characteristic	Negative, N = 191^a	Positive, N = 40^a	p-value^b
Age Group
18–23	22 (12%)	1 (2.5%)
24–29	42 (22%)	3 (7.5%)
30–35	37 (19%)	3 (7.5%)
36–41	34 (18%)	6 (15%)
42–47	29 (15%)	6 (15%)
48–53	18 (9.4%)	6 (15%)
54–59	7 (3.7%)	7 (18%)
60–65	2 (1.0%)	4 (10%)
66–71	0 (0%)	3 (7.5%)
84–89	0 (0%)	1 (2.5%)
Sex			0.2
Female	165 (86%)	31 (78%)
Male	26 (14%)	9 (23%)
Surgical History			0.007
Injection aesthetic	1 (0.5%)	0 (0%)
Major Procedures	1 (0.5%)	0 (0%)
Major with general anesthesia	49 (26%)	16 (40%)
Major with local anesthesia	0 (0%)	2 (5.0%)
Minor Procedures	3 (1.6%)	2 (5.0%)
No previous surgeries	137 (72%)	20 (50%)
Drug History			<0.001
Drugs for cardiovascular	0 (0%)	1 (2.5%)
Drugs for chronic disease	2 (1.0%)	31 (78%)
Drugs for chronic disease + Supplements	0 (0%)	1 (2.5%)
Drugs for GI disease	1 (0.5%)	1 (2.5%)
Drugs for infections	1 (0.5%)	1 (2.5%)
No drugs intake	186 (97%)	4 (10%)
Oral contraceptive pills	0 (0%)	1 (2.5%)
Pain killers	1 (0.5%)	0 (0%)
Number of Nevi			0.8
<3	117 (61%)	23 (58%)
>10	38 (20%)	10 (25%)
3–10	36 (19%)	7 (18%)
Distribution of nevi
Abdomen	8 (4.2%)	0 (0%)
Back	9 (4.7%)	0 (0%)
Chest	2 (1.0%)	0 (0%)
Left lower leg	1 (0.5%)	0 (0%)
Lower third of the face	43 (23%)	11 (28%)
Middle third of the face	64 (34%)	12 (30%)
Multiple sites	18 (9.4%)	4 (10%)
Neck	23 (12%)	3 (7.5%)
Right lower leg	0 (0%)	1 (2.5%)
Right upper arm	2 (1.0%)	0 (0%)
Scalp	1 (0.5%)	1 (2.5%)
Shoulders	5 (2.6%)	0 (0%)
Sole	1 (0.5%)	0 (0%)
Underarm	2 (1.0%)	0 (0%)
Upper third of the face	12 (6.3%)	8 (20%)
Color of the nevus			0.4
Black	9 (4.7%)	2 (5.0%)
Brown	179 (94%)	36 (90%)
Others	1 (0.5%)	1 (2.5%)
Pink	2 (1.0%)	1 (2.5%)
Type of observed changes in the nevus			0.028
Bleeding	2 (1.0%)	0 (0%)
Color changes	10 (5.2%)	1 (2.5%)
Configuration	8 (4.2%)	3 (7.5%)
Multiple changes	68 (36%)	19 (48%)
No changes	88 (46%)	9 (23%)
Size changes	14 (7.3%)	8 (20%)
Ulceration	1 (0.5%)	0 (0%)
Observed Changes			0.006
No changes	88 (46%)	9 (23%)
Positive	103 (54%)	31 (78%)
Histopathology Findings			0.005
Acrokeratosis of Hopf	0 (0%)	1 (2.6%)
Basal cell carcinoma	0 (0%)	1 (2.6%)
Fibroepithelial polyp	3 (1.6%)	0 (0%)
Hyperkeratosis with acanthosis	0 (0%)	1 (2.6%)
Lentigo simplex	7 (3.7%)	2 (5.1%)
Polypoidal intradermal melanocytic blue nevi	166 (88%)	27 (69%)
Seborrheic keratosis	9 (4.8%)	6 (15%)
Small inclusion cyst with fibrosis and inflammation	2 (1.1%)	0 (0%)
Squamous papilloma	2 (1.1%)	1 (2.6%)

Notes: ^an (%). ^bPearson’s chi-squared test; Fisher’s exact test.