Dermatology - Dysplastic Melanocytic Nevus
Dysplastic nevi (DN) are distinct acquired pigmented lesions characterized by the abnormal growth of melanocytes, which are cells responsible for producing pigment. These lesions have the potential to develop into superficial spreading melanoma, a kind of skin cancer. They can appear spontaneously or as a component of a compound melanocytic nevus. Clinically, they are easily distinguishable from common acquired nevi due to their bigger size, more varied coloration, asymmetrical form, and uneven borders. They also exhibit specific histologic characteristics. Lesions typically develop in later infancy compared to common acquired nevomelanocytic nevi (NMN), which generally emerge in late childhood, shortly before puberty. Additional lesions persistently emerge over an extended period of time. While conventional nevomelanocytic nevi (moles) often follow a similar progression in a certain area of the body (such as junctional, compound, dermal), dysplastic nevi (DN) deviate from this pattern. DN may exhibit a combination of large and small, flat and elevated, tan and very dark lesions. The diagnosis is established through the clinical identification of characteristic and unique skin lesions, and further validated with dermoscopy. Once a diagnosis of DN is confirmed in a family member, it is advisable to also evaluate siblings, children, and parents for the condition. The differential diagnosis include congenital nevomelanocytic nevi, common acquired nevomelanocytic nevi (moles), superficial spreading malignant melanoma, melanoma in situ, lentigo maligna, Spitz nevus, and pigmented basal cell carcinoma. The excision of DN should be performed carefully with precise margins. The use of laser or other physical destruction methods should be avoided since they do not allow for histopathologic verification of diagnosis. It is crucial to closely monitor patients with DN in the familial melanoma context, and it is essential to conduct regular photographic follow-up. It is crucial to educate patients about the distinct characteristics of DN, malignant melanoma, and typical acquired NMN as digital dermoscopy provides the most dependable results. Advise patients to refrain from sunbathing or utilizing tanning salons, and to apply sunscreens while exposed to the outdoors.
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