Correlation of clinical and histopathologic features in clinically atypical melanocytic nevi

Article Abstract:

Nevi are commonly referred to as moles, the tiny mounds on the skin that are often heavily pigmented. Moles have a characteristic structure, and moles with abnormal structure are referred to as dysplastic, or dysplastic nevi. The subject is of considerable interest, since patients with dysplastic nevi are at especially high risk for melanoma. Melanoma is rapidly becoming one of the most common cancers; it is the most common form of skin cancer, and one which is readily treatable in its early stages, but very deadly once it has begun to advance. The diagnosis of dysplasia for a nevus may be determined in one of two ways, either on the basis of clinical examination (by visual observation and touch) or on the basis of removal and examination of the nevus under the microscope. Perhaps surprisingly, researchers have paid little attention to how well the clinical diagnosis of dysplastic nevus correlates with the same diagnosis based upon pathological examination. To learn more about the appearance and diagnosis of a dysplastic nevus, the most atypical (abnormal appearing) nevus was examined in each of 153 patients with melanoma. Clinical features such as size, color, irregular or indistinct border, and lack of symmetry were recorded. These features were then correlated with the histopathologic (abnormal tissue) features, which are visible under the microscope. These histopathologic features include such things as abnormal architecture of the cells, and unusual appearance of the nuclei or the cytoplasm of the cells. The clinical feature that correlated with the greatest number of histologic abnormalities was the size of the nevus. Other clinical features that correlated with the histopathologic findings included pink color, irregular or indistinct border, and a macula, or small colored spot within the nevus. These results should help the clinician provide a more precise diagnosis of dysplastic nevus. (Consumer Summary produced by Reliance Medical Information, Inc.)

Melanocytes, Dysplastic nevus syndrome

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Clinical characteristics of malignant melanoma developing in persons with dysplastic nevi

Article Abstract:

A nevus is more colloquially called a mole. Dysplastic nevi, i.e. those with abnormal tissue structure, identify individuals who are at increased risk for malignant melanoma, an aggressive cancer of the skin. Some of the features which characterize dysplastic nevi are large size, i.e. greater than 8 mm; a large number, say more than 100; irregular coloration; irregular borders which fade into the surrounding skin, and heterogeneity. Since malignant melanoma is one of the more aggressive cancers, the identification of early stages of melanoma would be important. To study the initial stages of malignant melanoma, 452 individuals with dysplastic nevi were followed for an average time of 27 months. During that time 16 patients developed 18 cancers. Twelve of the 18 malignant melanomas were still in situ, indicating that they had not yet spread to neighboring tissue and therefore had an excellent prognosis. Although some authorities indicate that the appearance of new black pigmentation in a mole is the best sign of an early melanoma, only 4 of the 18 melanomas observed here were black. The principle clue for a malignant melanoma in this study was a change in size, shape, or color. For this reason, whole body photographs taken for comparison were very useful in identifying cancerous changes. (Consumer Summary produced by Reliance Medical Information, Inc.)

Mole (Dermatology), Nevus, Birthmarks

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Early diagnosis of cutaneous melanoma: Revisiting the ABCD criteria

Article Abstract:

The study reviews key literature regarding the applications and utility of ABCD, revisit the D criterion in light of recent data regarding small-diameter melanomas and consider expansion of the acronym to ABCDE, which includes a criterion for evolving. It concluded that the ABCD criteria for the gross inspection of pigmented skin lesions and early diagnosis of cutaneous melanoma should be expanded to ABCDE.

United States, Early intervention

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