Dysplastic nevus physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2]
Overview
The only way to diagnose dysplastic nevus is to remove tissue and check it for dysplasia.
Physical Examination and Diagnosis
Skin Examination
Features that characterize a nevus as dysplastic linclude:[1][2][3][4][5]
- Asymmetry (one half of the lesion does not match the other in terms of shape or color).
- Notched, irregular, or ill-defined borders fading into surrounding skin
- Variegated color, with areas of pink, tan, brown, or dark brown.
- Diameter in one dimension >5 mm.
- Prominent macular component, sometimes with a papular center ("fried egg" or "target" appearance).
- Mammillated (cobblestone) topography.
Progression to melanoma most often manifests as a new focal area of deep pigmentation or firm elevation.
Signature nevus
- In individuals with multiple nevi, the predominant group of nevi that share similar clinical and dermoscopic features defines the "signature nevus".
Ugly duckling" sign
- The identification of nevi that appear different from the signature nevi, called "ugly ducklings" or "outliers", has been suggested as a screening method for the detection of melanoma in patients with many nevi, including those with many atypical nevi
References
- ↑ Lee H, Kwon K (March 2017). "A mathematical analysis of the ABCD criteria for diagnosing malignant melanoma". Phys Med Biol. 62 (5): 1865–1884. doi:10.1088/1361-6560/aa562f. PMID 28036304.
- ↑ Tsao H, Olazagasti JM, Cordoro KM, Brewer JD, Taylor SC, Bordeaux JS, Chren MM, Sober AJ, Tegeler C, Bhushan R, Begolka WS (April 2015). "Early detection of melanoma: reviewing the ABCDEs". J. Am. Acad. Dermatol. 72 (4): 717–23. doi:10.1016/j.jaad.2015.01.025. PMID 25698455.
- ↑ Bønnelykke-Behrndtz ML, Schmidt H, Christensen IJ, Damsgaard TE, Møller HJ, Bastholt L, Nørgaard PH, Steiniche T (December 2014). "Prognostic stratification of ulcerated melanoma: not only the extent matters". Am. J. Clin. Pathol. 142 (6): 845–56. doi:10.1309/AJCPW56PHGLFTKZC. PMID 25389339.
- ↑ Callender GG, McMasters KM (2011). "What does ulceration of a melanoma mean for prognosis?". Adv Surg. 45: 225–36. PMID 21954690.
- ↑ Tromme I, Sacré L, Hammouch F, Richez P, Degryse JM, Speybroeck N (December 2018). "Melanoma diagnosis: predictive value of macroscopic changes observed by the patient". Melanoma Res. 28 (6): 611–617. doi:10.1097/CMR.0000000000000496. PMID 30192302.