Dysplastic nevus: Fact and fiction - 17/08/15

Doi : 10.1016/j.jaad.2015.04.029

Cliff O. Rosendahl, MBBS, PhD ^a, Jane M. Grant-Kels, MD ^b, Syril Keena T. Que, MD ^b,^⁎
^a School of Medicine, The University of Queensland, Australia
^b Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut

^∗Reprint requests: Syril Keena T. Que, MD, Department of Dermatology, University of Connecticut Health Center, 21 South Rd, Farmington, CT 06032.

Abstract

The term “dysplastic nevus” (DN) implies that this nevus exists as a distinct and defined entity of potential detriment to its host. We examine the current data, which suggest that this entity exists as histologically and possibly genetically different from common nevus, with some overlapping features. Studies show that a melanoma associated with a nevus is just as likely to arise in a common nevus as in DN. Furthermore, there is no evidence that a histologically defined DN evolves into a melanoma or that the presence of 1 or more DN on an individual patient confers any increased melanoma risk. We suggest that the term “dysplastic nevus” be abandoned so that the focus can shift to confirmed and relevant indicators of melanoma risk, including high nevus counts and large nevus size.

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Key words : B-K mole syndrome, BRAF, common nevus, congenital melanocytic nevus, cyclin-dependent kinase inhibitor 2A (CDKN2A), dysplastic nevus, familial atypical multiple-mole melanoma, melanoma, p16, p53

Abbreviations used : CMN, CN, DN, DNS, NIH, WHO