Dysplastic Nevi BT - Pathology of Pigmented Skin Lesions

Abstract

Dysplastic melanocytic nevi are common acquired melanocytic proliferations with distinct clinical and histologic features. This category of melanocytic lesions has been one of the most controversial terms introduced into dermatopathology and has resulted in completely divergent entrenched opinions as to its existence, diagnostic criteria, prevalence, and its significance [1–5]. Since dysplastic melanocytic nevi were first reported in 1978 by Wallace Clark and colleagues as histologically defined lesions in melanoma-prone families, there has been extensive debate about the definition, classification, and biologic importance of these lesions [6–8]. And although a number of authors object to the use of the term “dysplastic,” we think that it has been so much popularized that it is probably best to continue using it. The most important point that has been debated is whether dysplastic nevi represent premalignant lesions that will progress to melanoma or not. There are authors who view dysplastic nevi as a discreet entity of clinical significance and others who dismiss the concept entirely [4, 9–11]. It is unknown the probability of a particular dysplastic nevus to become melanoma; however, patients with a diagnosis of dysplastic nevus are more likely to have had or to have in the future a diagnosis of melanoma in some other area of their bodies (see also below).