Dysplastic nevus part I: Historical perspective, classification, and epidemiology - 14/12/22

Doi : 10.1016/j.jaad.2022.04.068

Roman Drozdowski, BS ^a, Natalie Spaccarelli, MD ^b, Margot S. Peters, MD ^c, Jane M. Grant-Kels, MD ^d,^e,^⁎
^a University of Connecticut School of Medicine, Farmington, Connecticut
^b Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
^c Departments of Dermatology and Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
^d Departments of Dermatology, Pathology and Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut
^e Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida

^∗Correspondence to: Jane M. Grant-Kels, MD, Dermatology Department, University of Connecticut School of Medicine, 21 South Rd, Farmington, CT 06032.Dermatology DepartmentUniversity of Connecticut School of Medicine21 South RdFarmingtonCT06032

Abstract

Since the late 1970s, the diagnosis and management of dysplastic nevi have been areas fraught with controversy in the fields of dermatology and dermatopathology. Diagnostic uncertainty and lack of standardized nomenclature continue to propagate confusion among clinicians, dermatopathologists, and patients. In part I of this CME review article, we summarize the historical context that gave rise to the debate surrounding dysplastic nevi and review key features for diagnosis, classification, and management, as well as epidemiology. We discuss essentials of clinical criteria, dermoscopic features, histopathologic features, and the diagnostic utility of total body photography and reflectance confocal microscopy in evaluating dysplastic nevi, with emphasis on information available since the last comprehensive review a decade ago.

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Key words : atypical melanocytic hyperplasia, atypical nevi, B-K mole syndrome, Bolognia sign, dermoscopy, dysplasia, dysplastic nevi, familial atypical multiple mole-melanoma syndrome, melanocytic nevi, melanoma, MPATH-Dx, reflectance confocal microscopy, total body photography

Abbreviations used : AAD, ASDP, DN, MPATH-Dx, NIH, RCM, WHO