Dermoscopic Classification of Atypical Melanocytic Nevi (Clark Nevi)

Abstract

To create a dermoscopic classification of atypical melanocytic nevi (Clark nevi) and to investigate whether individuals bear a predominant type.Design: Digital dermoscopic images of Clark nevi were classified according to structural features, ie, reticular, globular, or homogeneous patterns or combinations of these types. The nevi were also characterized as central hypopigmented or hyperpigmented, eccentric peripheral hypopigmented or hyperpigmented, or multifocal hypopigmented or hyperpigmented. Setting: Two pigmented skin lesion clinics. Patients: We examined 829 Clark nevi on 23 individuals. Main Outcome Measure: A reliable dermoscopic classification of Clark nevi and frequency of different dermoscopic types.

Nevo displásico (nevo atípico)

“…One is based on the presence of at least three of the five following characteristics: (1) diameter larger than 5mm, (2) poorly-defined borders, (3) irregular margins, (4) multiple colors, (5) presence of macular and papular components ( Figure 1). 13,19 The ABCD (E) rule can also be useful in the diagnosis of atypical nevus. The lesion is considered atypical when it is Asymmetrical (A), with uneven Borders (B), multiple Colors (C), Diameter larger than 5mm (D) and Elevation above the surface, with a FIGURE 1: Young patient with common and atypical nevi in the trunk.…”

“…Eight hundred lesions clinically consistent with atypical nevi were included and four distinct subtypes were described: 13.20 Atypical nevus with central hypopigmentation: a variant of the reticular-homogeneous type, with a central hypopigmented area without the presence of other dermoscopic structures and pigment network throughout the periphery (Figure 3). 13,20 Atypical nevus with central hyperpigmentation: this type is also called black nevus or hypermelanocytic nevus and represents a variant composed of peripheral pigment network and central hyperpigmentation (black lamella) (Figure 4). 13,20 Atypical nevus with multifocal hypo-and hyperpigmentation: it is characterized by areas of hypopigmentation interspersed with areas of hyperpigmentation giving it a mottled appearance ( Figure 5).…”

“…13,20 Atypical nevus with central hyperpigmentation: this type is also called black nevus or hypermelanocytic nevus and represents a variant composed of peripheral pigment network and central hyperpigmentation (black lamella) (Figure 4). 13,20 Atypical nevus with multifocal hypo-and hyperpigmentation: it is characterized by areas of hypopigmentation interspersed with areas of hyperpigmentation giving it a mottled appearance ( Figure 5). 13,20 Atypical nevus with eccentric pigmentation: this type is the most important because it includes early melanoma as differential diagnosis.…”

“…13,20 Atypical nevus with multifocal hypo-and hyperpigmentation: it is characterized by areas of hypopigmentation interspersed with areas of hyperpigmentation giving it a mottled appearance ( Figure 5). 13,20 Atypical nevus with eccentric pigmentation: this type is the most important because it includes early melanoma as differential diagnosis. It is characterized by the presence of peripheral hyperpigmentation that reaches the border of the lesion.…”

“…1, 10.11 The major challenge in relation to atypical nevus lies in its controversial nomenclature, clinical diagnosis, dermoscopic criteria, histopathological diagnosis and molecular aspects. 6,12,13 …”