Dysplastic nevus physical examination

Dysplastic nevus Microchapters
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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:

• 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