Although difficult to quantify, there is some benefit to removing a severely atypical nevus
, both for risk of transformation and for a patient's peace of mind," they wrote (JAMA Oncol.
It is important to recognize the precursor lesions of malignant melanoma including PAM with atypia, an enlarging or atypical nevus
Finding a truly atypical nevus
necessitates specialist review.
atypical nevus syndrome with a personal and family history of melanoma
atypical nevus syndrome with just a family history of melanoma
TABLE 1 Risk factors for malignant melanoma (13) Risk factors that should prompt an annual skin survey RR (LOE) * Atypical nevus syndrome with personal and 500 (1b) family history of melanoma Changing mole >400 (4) Atypical nevus syndrome with family history 148 (1b) ([dagger]) of melanoma Age [greater than or equal to] 15 88 (2c) Dysplastic moles 7-70 (3b) History of melanoma before age 40 23 (2b) Large congenital nevus ([greater than or 17 (2b) equal to] -15 cm) Caucasian race 12 (2b) Lentigo maligna 10 (2c) Atypical nevi 7-27 (3b) Regular use of tanning bed before age 30 7.
When misdiagnosed, carcinomas were incorrectly identified as viral wart and graft-versus-host disease for SCC, and psoriasis, acrochordon, wart, nevus, and atypical nevus
In most cases, the histologic differential diagnosis was between Spitz nevus and spitzoid melanoma or between atypical nevus (such as variants of deep penetrating/clonal/inverted type-A nevus, pigmented spindle cell nevus, atypical genital nevus, atypical conjunctival nevus showing cytologic atypia, mitotic activity, limited maturation, or proliferative nodules, among others) and nevoid melanoma (Table 1).
For each major diagnostic category of histologically ambiguous lesion (spitzoid tumors, lesions raising a differential diagnosis of an atypical nevus versus nevoid melanoma, and dysplastic nevus versus superficial spreading melanoma), Table 1 shows the initial MelanoSITE results and the final FISH result interpretation after correcting for false-positive results.
Other melanoma risk factorswere skin types I or II and having more than 49 common nevi or more than 1 clinical atypical nevus
If the FISH result is normal and the initial impression was that of a severely atypical but benign lesion, the FISH findings are interpreted as reassuring, and in most cases a biopsy is reported as consistent with an atypical nevus
26) Benign nevi are not rare in acral locations, which was found in mole distribution studies in patients with atypical nevus