Product Code Database
A dysplastic nevus or atypical mole is a nevus (mole) whose appearance is different from that of common moles. In 1992, the NIH recommended that the term dysplastic nevus be avoided in favor of the term atypical mole. An atypical mole may also be referred to as an atypical melanocytic nevus, atypical nevus, B-K mole, Clark's nevus, dysplastic melanocytic nevus, or nevus with architectural disorder. (2025). 9781416029991, Mosby. ISBN 9781416029991
Dysplastic nevi often grow to larger than ordinary moles and may have irregular and indistinct borders. Their color may not be uniform and may range from light pink to very dark brown. They usually begin flat, but parts may be raised above the skin surface. See ABCDE and "ugly duckling" characteristics below.
Dysplastic nevi can be found anywhere, but are most common on the Torso in men, and on the calves in women.
There is some controversy in the dermatology community as to whether or not the "dysplastic" or "atypical" nevus exists. Some have argued that the terms dysplastic and atypical only refer to diagnostic uncertainty, as opposed to biologic uncertainty, and that the lesion is either a nevus or melanoma from the very beginning, as opposed to some kind of "premalignant stage"; it is only the clinician who is unsure. Some have also argued that even if such nevi do exist, studies have shown that clinicians are unable to reliably identify them anyway, meaning there is no point to even using the concept.
It is common among white people.
The abbreviation ABCDE has been useful for helping health care providers and laypersons remember the key characteristics of a melanoma. Changes (in shape, size, color, itching or bleeding) should be brought to the attention of a dermatologist.
A popular method for remembering the signs and symptoms of melanoma is the mnemonic "ABCDE":
The E is sometimes omitted, as in the ABCD guideline. A weakness in this system is the D. Many melanomas present themselves as lesions smaller than 6 mm in diameter. An astute physician will examine all abnormal moles, including ones less than 6 mm in diameter. Unfortunately for the average person, many seborrheic keratoses, some lentigo senilis, and even warts may have ABCD characteristics, and cannot be distinguished from a melanoma without a trained eye or dermatoscopy.
A recent and novel method of melanoma detection is the "Ugly Duckling Sign". It is simple, easy to teach, and highly effective in detecting melanoma. Simply, correlation of common characteristics of a person's skin lesion is made. Lesions that greatly deviate from the common characteristics are labeled as an "Ugly Duckling", and a dermatologist exam is required. The "Little Red Riding Hood" sign suggests that individuals with fair skin and light-colored hair might prove more challenging. These fair-skinned individuals often have lightly pigmented or amelanotic melanomas which will not present with easy to observe color changes and variation in colors. The borders of these amelanotic melanomas are often indistinct, making visual identification without a dermatoscope (dermatoscopy) very difficult. A dermatoscope must be used to detect "ugly ducklings" among those with light skin or blonde/red hair.
People with a personal or family history of skin cancer or of dysplastic nevus syndrome (multiple atypical moles) should see a dermatologist at least once a year to be sure they are not developing melanoma.
Most dermatologists and dermatopathologists use a system devised by the NIH for classifying melanocytic lesions. In this classification, a nevus can be defined as benign, having atypia, or being a melanoma. A benign nevus is read as (or understood as) having no cytologic or architectural atypia. An atypical mole is read as having architectural atypia and having (mild, moderate, or severe) cytologic (melanocytic) atypia. Usually, cytologic atypia is of more important clinical concern than architectural atypia. Usually, moderate to severe cytologic atypia will require further excision to make sure that the surgical margin is completely clear of the lesion.
The most important aspect of the biopsy report is that the pathologist indicates if the margin is clear (negative or free of melanocytic nevus), or if further tissue (a second surgery) is required. If this is not mentioned, usually a dermatologist or clinician will require further surgery if moderate to severe cytologic atypia is present – and if residual nevus is present at the surgical margin.
==Additional images==
|
|
