"You don't need to biopsy an atypical nevus
to call it atypical.
Unfortunately, diagnosis by standard histologic criteria can be very difficult, and distinction of melanoma from an atypical nevus
may be impossible in some cases.
(1,3) The differential diagnosis of the EAC nevi should include seborrheic keratosis, senile keratosis, pigmented actinic keratosis, benign pigmented keratosis, common warts, pigmented fibrous histiocytoma, squamous papilloma, blue nevus, atypical nevus
, malignant melanoma, and even squamous cell carcinoma.
Clinical data (age, sex, phototype based on Fitzpatrick scale I-VI, lesion site, growth pattern, stage, number of nevus, atypical nevus
), histopathological data (Breslow index, Clark level, ulceration, mitotic index, regression) and treatment data were assessed.
The teledermoscopic diagnoses were pigmented basal cell carcinoma (3), intradermal nevus (6), seborrheic keratosis (4), benign melanocytic lesion (12), blue nevus (3), intracorneal hematoma (1), atypical nevus
melanocytic suspicion (2), dermatofibroma (1), congenital nevus (1), solar lentigo (2), and melanoma (4).
It is important to recognize the precursor lesions of malignant melanoma including PAM with atypia, an enlarging or atypical nevus
. (2) The limbal epithelium, being rich in stem cells, was considered a common site for limbal tumours.
Interestingly, only one of the 30 nevi (atypical nevus
, 3%) expressed Rad6 in >80% of the cells, and none of the primary and metastatic melanomas expressed Rad6 in <40% of the cells (Figure 2).
Finding a truly atypical nevus
necessitates specialist review.
* atypical nevus
syndrome with a personal and family history of melanoma
If a principle like this were extensively applied, a lesion presently diagnosed as "superficial spreading melanoma" should be a posteriori classified as a "melanoma" only if the patient developed metastases or died, but regarded as "nevus" or as "atypical nevus
" if the patient survived.
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.
Other melanoma risk factorswere skin types I or II and having more than 49 common nevi or more than 1 clinical atypical nevus
. The increased risk associated with childhood sunburn remained after adjusting for skin type.