Dysplastic Nevi

Dysplastic nevi have been a subject of much debate since their original description in 1978. Although some question the biological potential of dysplastic nevi themselves, several studies have shown that their presence confers substantial risk for melanoma. In addition to predisposing patients to melanoma, dysplastic nevi have been shown to harbor genetic mutations, indicating their position on a continuum between banal nevi and melanomas. Dysplastic nevi are also clinically relevant as mimickers of melanoma, and can be challenging diagnostically. This article reviews the history, epidemiology, biology and genetics, clinical features, histopathologic features, and management guidelines for patients with these lesions.

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The dysplastic nevus has been the subject of much debate in terms of its clinical and histologic definitions as well as its biologic potential.
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Dysplastic nevi are acquired melanocytic lesions that often mimic melanoma clinically and portend an increased risk for melanoma, although it is highly unusual that dysplastic nevi themselves eventuate into melanoma.
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Management of patients with dysplastic nevi and dysplastic nevus syndrome should include vigilant follow up, thorough physical examination, and timely biopsy of suspicious lesions.

Key Points

Introduction

Dysplastic nevi have been a subject of much debate since their original description in 1978. Although some question the biological potential of dysplastic nevi themselves, several studies have shown that the presence of dysplastic nevi confers a substantial risk for melanoma. In addition to predisposing patients to melanoma, dysplastic nevi have been shown to harbor genetic mutations, indicating their position on a continuum between banal nevi and melanoma. Dysplastic nevi are also clinically relevant as mimickers of melanoma, despite dysplastic nevi themselves only rarely progressing to melanoma, and can be quite challenging diagnostically. Given the controversy surrounding dysplastic nevi, this article reviews the history, epidemiology, biology and genetics, clinical features, histopathologic features, and management guidelines for patients with these lesions.

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