ReportsCorrelation between clinical atypia and histologic dysplasia in acquired melanocytic nevi☆,☆☆
Section snippets
Terminology
In the present study the terms hereafter listed have been defined as follows:
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Clinically dysplastic nevus, nevus with clinical atypia, or atypical mole2, 4, 6, 7, 9, 16, 22, 25, 26: Acquired melanocytic nevus with a macular component in association with at least 3 of the following attributes: (1) asymmetry, (2) variegation of color (haphazard mixture of tan, dark brown, and pink colors), (3) erythema, (4) irregular borders, (5) indistinct margins that tend to fade into the adjacent normal skin
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Results
The 940 melanocytic nevi were excised from 898 patients (512 females, 386 males; age range 19 to 72 years, average age 33 years). A total of 570 nevi were located on the trunk and 370 on the limbs; 499 (53%) nevi were judged clinically to be dysplastic and 441 (47%) nondysplastic. For the purpose of the study, the lesions were arbitrarily subdivided into 2 groups on the basis of clinical diameter: group A, 3 to 5 mm (290 cases); group B, >5 mm (650 cases). In group A, 61 (21%) nevi were
Discussion
Although there is some controversy,45, 46 the dysplastic nevus is at present regarded to be a distinct clinicopathologic entity by many authors.4, 5, 28, 47 This concept is grounded primarily in the assumption that there are reliable criteria to identify dysplastic nevi both clinically and histologically.22, 26, 27, 29, 31, 33, 34, 35, 36 Moreover, various studies have ascertained a significant correlation between clinical atypia and histologic dysplasia.26, 37, 48 The present clinicopathologic
Acknowledgements
We thank Anna Luisa Bucci, Luciana Martini, and Leonilde Sposato for technical assistance and Dr Giovanna Zambruno for helpful discussion.
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Dysplastic nevus part I: Historical perspective, classification, and epidemiology
2023, Journal of the American Academy of DermatologyCitation Excerpt :The question of whether there is a correlation between clinical and histologic atypia also has been investigated. In one study, clinical dermatologists categorized nevi as “clinically dysplastic or nondysplastic,” and dermatopathologists were then asked to identify whether there was evidence of histologic “dysplasia” in the biopsied lesions.57 The study demonstrated poor sensitivity, specificity, and statistical agreement between clinical atypia and histologic dysplasia.
A nongrading histologic approach to Clark (dysplastic) nevi: A potential to decrease the excision rate
2016, Journal of the American Academy of DermatologyCitation Excerpt :Approximately 20% of the cases assigned to the excision group were not captured as excision specimens. As histologic atypia may not correlate with clinical atypia,10 some of these cases may represent those cases that the clinicians decided to monitor rather than excising them. Alternatively, they were excised and sent to a different laboratory.
Dysplastic nevus: Fact and fiction
2015, Journal of the American Academy of DermatologyThe dysplastic nevus: From historical perspective to management in the modern era: Part II. Molecular aspects and clinical management
2012, Journal of the American Academy of DermatologyCitation Excerpt :Nevertheless, DN share some histologic features of nondysplastic or “common” nevi (CN), including the presence of neoplastic nests of melanocytes, and features of melanoma such as cytologic atypia and dermal inflammatory response.1 The benign lesions (DN and CN) cannot be distinguished from each other based on clinical examination alone,2,3 and DN often have some clinical features associated with melanoma, such as an irregular border and the asymmetric distribution of pigmentation.4,5 Given these considerations, this review will focus on studies based on lesions that have been defined histologically.
The dysplastic nevus: From historical perspective to management in the modern era: Part I. Historical, histologic, and clinical aspects
2012, Journal of the American Academy of DermatologyCitation Excerpt :The overall concordance between clinical and histologic atypia was fair, as the presence of macularity and color variegation correlated somewhat with higher grades of histological atypia. Similarly, Annessi et al65 found very poor correlation between nevi that were clinically atypical and histologically dysplastic. In this study, 940 acquired nevi were clinically assessed by five dermatologists, and then blindly examined histologically by a single experienced dermatopathologist.
In vivo confocal microscopy for detection and grading of dysplastic nevi: A pilot study
2012, Journal of the American Academy of Dermatology
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Reprint requests: Giorgio Annessi, MD, Laboratorio di Dermatopatologia, Istituto Dermopatico dell'Immacolata, Via Monti di Creta 104, 00167 Roma, Italy.
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J Am Acad Dermatol 2001;45:77-85