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Benign Melanocytic Lesions
Published in Ashfaq A Marghoob, Ralph Braun, Natalia Jaimes, Atlas of Dermoscopy, 2023
Konstantinos Liopyris, Cristian Navarrete-Dechent, Silvia E. Mancebo, Michael A. Marchetti
Clinically, a banal nevus is a symmetric, uniformly pigmented (usually brown), flat, slightly elevated, or raised lesion with regular borders and a round or oval shape. On the other hand, atypical/dysplastic nevi are acquired nevi that have a diameter >5 mm, have a prominent macular component, and variably display asymmetry, notched/irregular/ill-defined borders, and variegated colors. Some authors have proposed replacing the term atypical/dysplastic nevus with large acquired melanocytic nevus to more accurately reflect the etiology, morphology, and biology of this lesion (11).
Melanomas
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
Dysplastic nevi are acquired pigmented skin lesions. These are usually larger than regular nevi and measure 6 to 12 mm. They consist of papular or plaque components, with an irregular border with a pinkish component that fades in the surrounding skin. These lesions are multicolored and can be seen on the skin of the back or sun-protected areas such as the buttocks, perineum, pubis, or scalp. While common nevi average 25 to 30 in number and do not develop after the age of 40, dysplastic nevi are found in the hundreds and continue to appear throughout life. Familial dysplastic nevi may be inherited as an autosomal dominant trait.13-15 Patients with dysplastic nevi have a lifetime risk of developing melanoma in the range of 5 to 10%.
Basic dermatology in children and adolescents
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Kalyani Marathe, Kathleen Ellison
Dysplastic nevi have a distinct appearance. Clinically, these lesions will have one or more of the features described in monitoring for melanoma (discussed later in this chapter). The presence of one or more of these features does not ensure that the nevus is dysplastic; rather, they must be considered in the context of the individual patient and the particular lesion. A helpful rule of thumb for patients and parents is the “ugly duckling” principle: atypical nevi often stand out from the patient's other moles as being unusual in morphology.
Management of dysplastic nevi: a 6 year follow-up survey assessing practice trends among US dermatologists
Published in Journal of Dermatological Treatment, 2023
Nicholas Brownstone, Danny Zakria, Darrell Rigel
The diagnosis and management of dysplastic nevi (DN) has been, and remains, controversial (1). The goal of this study was to assess the continuing evolution of practice trends for DN evaluation and management over a 20 year interval by comparing responses to our previous Journal of the American Academy of Dermatology (JAAD) studies published in 2001 and 2015 (2,3). Using similar methodologies from the prior studies, 479 dermatologists responded to survey questions about their management of dysplastic nevi (2). Data were collected about respondent’s years in practice (YIP, categorized as less than 5 years, 6–14 years, 15–25 years and 26 years plus) and practice type. Descriptive statistics were analyzed with Microsoft Excel®. Specific significant differences noted between 2015 and 2021 survey and the corresponding subset comparative analysis (based on clinical experience) is displayed in Table 1.
The Markers Auxiliary in Differential Diagnosis of Early Melanomas and Benign Nevi Sharing Some Similar Features Potentially Leading to Misdiagnosis – A Review of Immunohistochemical Studies
Published in Cancer Investigation, 2022
Łukasz Kuźbicki, Anna A. Brożyna
The method for the improvement of the differential diagnosis of melanocytic skin lesions seems to be the simultaneous assessment of several markers. In a study conducted on 33 dysplastic nevi and 122 melanomas, 12 potential markers were immunohistochemically tested. Four molecules were selected for which the greatest differences between benign and malignant lesions were shown: BCL2-like protein 11 (Bim), Brahma-related gene-1 expression protein product (BRG1), cullin 1 (Cul1), and an inhibitor of growth family member 4 (ING4). When analyzing the efficiency of diagnostic tests based on the level of these proteins, the following AUC values were obtained: 0.72 for ING4-Cul1, 0.77 for ING4-Cul1-BRG1, and 0.84 for ING4-Cul1-BRG1-Bim (63). However, the group of examined melanomas included 74 primary melanomas without distant metastases and 48 metastatic melanomas, and the demonstrated AUC values were also available in other studies for single markers (Table 2). In another work, double staining of Ki-67 and Melan-A was performed for 233 common nevi, 2 Spitz nevi, 35 dysplastic nevi, 22 melanomas in situ, and 84 melanomas (including 48 cases with tumor thickness ≤1 mm). When the combined dermal and epidermal index for all examined lesions was analyzed, AUC = 0.89 was obtained. Importantly, for the diagnostic test of distinguishing melanomas in situ from junctional nevi based on the epidermal index, the AUC value amounted to only 0.66 (64).
Genomic analysis of adult case of ocular surface giant congenital melanocytic nevus and associated clinicopathological findings
Published in Ophthalmic Genetics, 2020
Lindsay A McGrath, Jane M Palmer, Andrew Stark, William Glasson, Sunil K Warrier, Kevin Whitehead, Hayley Hamilton, Kelly Brooks, Peter A Johansson, Nicholas K Hayward
This otherwise healthy patient had no cutaneous freckling and very few moles, she reported a history of >20 severe sunburns causing pain and blistering in her early 20s, as well as the excision of one pigmented lesion, a dysplastic nevus from her neck at 46 years, although no histopathological diagnosis was available. Additionally, the patient reported no significant personal history of cutaneous melanoma or other malignancy, including keratinocyte skin cancers. There was no known family history of congenital melanocytic lesions. Known family history of malignancy comprised the patient’s father, diagnosed with pancreatic cancer and deceased shortly after from metastatic disease at 75 years. Other paternal history included her deceased grandmother and two uncles with cancer, types unknown. The Māori maternal history included her mother’s kidney cancer at 61 years (alive at 68 years) and two aunts deceased from metastatic breast cancer.