{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:38:38Z","timestamp":1786117118934,"version":"build-2736575974"},"reference-count":71,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Clinical Significance: Pregnancy-associated melanoma (PAM) is clinically challenging because the physiological pigmentary and naevus changes in pregnancy can obscure early malignancy, and the long-standing assumption that the hormonal milieu of pregnancy drives melanocytic transformation continues to shape clinical expectations. We present a case of postpartum-persistent melanoma in situ and use it to anchor a molecular reappraisal of that hormonal hypothesis. Case Presentation: We describe the clinical, dermoscopic, histopathological, and immunohistochemical findings in a 32-year-old woman with a peri-umbilical naevus that changed during the third trimester and persisted twelve months postpartum, and we review the hormonal, immunological, and diagnostic literature relevant to PAM. Dermoscopy showed a multicomponent pattern with asymmetry, irregular structureless areas, peripheral pseudopods, and central regression; excisional biopsy demonstrated an atypical intraepidermal melanocytic proliferation without dermal invasion (melanoma in situ, pTis cN0 cM0, Stage 0), with Melan-A positivity and reduced p16. The reviewed evidence indicates that melanomas lack classical oestrogen\/progesterone receptors and that the dominant oestrogen and \u03b1-MSH signals act through non-classical, differentiating pathways (GPER, MC1R) that are growth-suppressive rather than oncogenic, while pregnancy provides an immunologically permissive and diagnostically obscuring context. Conclusions: Pregnancy is better understood not as a hormonal driver of melanoma but as a permissive and obscuring state in which the principal preventable harm is diagnostic delay; suspicious lesions in pregnant or postpartum women warrant the same urgency as in other patients, and structured dermoscopic surveillance of at-risk women is the rational response.<\/jats:p>","DOI":"10.3390\/diagnostics16152485","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T13:03:27Z","timestamp":1786021407000},"page":"2485","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pregnancy-Associated Melanoma: A Molecular Reappraisal of the Hormonal Hypothesis, Illustrated by a Postpartum-Persistent Melanoma In Situ"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8901-8271","authenticated-orcid":false,"given":"Laura","family":"Maghiar","sequence":"first","affiliation":[{"name":"Department of Psycho-Neurosciences and Rehabilitation, Faculty of Medicine and Pharmacy, University of Oradea, Universit\u0103\u021bii Str., No. 1, 410087 Oradea, Romania"},{"name":"Department of Dermatovenerology, Clinical County Emergency Hospital Bihor, 410169 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrada","family":"Iftode","sequence":"additional","affiliation":[{"name":"Department of Toxicology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"},{"name":"Research Centre for Pharmaco-Toxicological Evaluation, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5219-5466","authenticated-orcid":false,"given":"Andreea-Adriana","family":"Neam\u021bu","sequence":"additional","affiliation":[{"name":"Department of Toxicology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"},{"name":"Research Centre for Pharmaco-Toxicological Evaluation, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"},{"name":"Department of Pathology, Clinical County Emergency Hospital of Arad, Andrenyi Karoly Str., No. 2\u20134, 310037 Arad, Romania"},{"name":"Department of Pathology, \u201cPius Brinzeu\u201d Clinical County Emergency Hospital Timisoara, Liviu Rebreanu Boulevard, No. 156, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodor-Andrei","family":"Maghiar","sequence":"additional","affiliation":[{"name":"Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Universit\u0103\u021bii Str., No. 1, 410087 Oradea, Romania"},{"name":"Department of Surgery, Pelican Hospital, Corneliu Coposu Str., No. 2, 410450 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul","family":"Chioibas","sequence":"additional","affiliation":[{"name":"Department of Surgery I, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"},{"name":"CBS Medcom Hospital, Popa Sapca Str., No. 12, 300047 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Haj-Ali","sequence":"additional","affiliation":[{"name":"Department of Toxicology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"},{"name":"Research Centre for Pharmaco-Toxicological Evaluation, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Dumitrescu","sequence":"additional","affiliation":[{"name":"Department of Toxicology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"},{"name":"Research Centre for Pharmaco-Toxicological Evaluation, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciprian-Nicu\u0219or","family":"Solomon","sequence":"additional","affiliation":[{"name":"1st Clinic of Obstetrics and Gynecology, \u201cPius Brinzeu\u201d Clinical County Emergency Hospital Timisoara, Liviu Rebreanu Boulevard, No. 156, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1552-7961","authenticated-orcid":false,"given":"Valentin-Cristian","family":"Iovin","sequence":"additional","affiliation":[{"name":"Doctoral School Department, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Center of Immuno-Physiology and Biotechnologies, Department of Functional Sciences, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Department of Functional Sciences, Physiology, Centre of Immuno-Physiology and Biotechnologies (CIFBIOTEH), \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1405-6836","authenticated-orcid":false,"given":"Ovidiu","family":"Tica","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 1 Decembrie Ave., No. 10, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5998-9488","authenticated-orcid":false,"given":"Anca","family":"Huniadi","sequence":"additional","affiliation":[{"name":"Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Universit\u0103\u021bii Str., No. 1, 410087 Oradea, Romania"},{"name":"Preclinical Sciences Department, Faculty of Medicine and Pharmacy, University of Oradea, Universit\u0103\u021bii Str., No. 1, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina-Adriana","family":"Dehelean","sequence":"additional","affiliation":[{"name":"Department of Toxicology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"},{"name":"Research Centre for Pharmaco-Toxicological Evaluation, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilarie","family":"Brihan","sequence":"additional","affiliation":[{"name":"Department of Psycho-Neurosciences and Rehabilitation, Faculty of Medicine and Pharmacy, University of Oradea, Universit\u0103\u021bii Str., No. 1, 410087 Oradea, Romania"},{"name":"Department of Dermatovenerology, Clinical County Emergency Hospital Bihor, 410169 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Cosgarea, I., Trevisan-Herraz, M., Ungureanu, L., and Zalaudek, I. 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