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Giornale Italiano di Dermatologia e Venereologia 1998 August;133(4):257-63

Copyright © 1998 EDIZIONI MINERVA MEDICA

language: Italian

Dysplastic nevus between past and future

Urso C.

Ospedale S. M. Annunziata - Firenze, U.O. Anatomia Patologica - Sez. Dermatopatologia

The dysplastic nevus concept originated from studies on familial melanoma. In 1978, a familial syndrome, characterized by numerous nevi, implying an increased risk for melanoma, was reported (B-K mole syndrome), subsequently followed by the identification of an analogous sporadic syndrome (Dysplatic Nevus Syndrome). Dysplatic nevus was described as a distinct variant of melanocytic nevus, larger than 5 mm, variegated in color, with irregular borders. Histologically, it was described as characterized by melanocytic atypical hyperplasia or dysplasia, lentiginous or epithelioid, dermal fibroplasia, vascular neoformation and lichenoid infiltrate. The definitions of such features have been criticized and this subjects has become highly confusing. However, rather than controversy, two elements really flawed dysplastic nevus: the evidence of the poor correlation between clinical phenotype and histological features and difficulties in clearly separating dysplastic from common nevi. However, although the proposed diagnostic features were inadequate, the dysplastic nevus concept (not all nevi are equal in terms of risk for melanoma) has still validity, because numerous special studies have showed that a fraction of nevi had characteristics intermediate between common nevus and melanoma. Future studies may improve our knowledge on this controversial subject in the hope that lesions implying an increased melanoma risk can be recognized.