Dysplastic (atypical) nevi: significance and management

The frequency of malignant melanoma is rising at an alarming rate. Familial dysplastic nevi have been shown to be markers for and perhaps even precursors of malignant melanoma. This paper addresses the clinical and histologic features of these lesions, the structural and functional abnormalities of the melanocytes present in dysplastic nevi, the systemic and genetic abnormalities seen in patients with the dysplastic nevus syndrome, and the risk of melanoma in persons with dysplastic nevi. Management of persons with dysplastic nevi should include stressing sunlight avoidance and self-examination, deciding which lesion(s) to surgically excise, a schedule of visits to the physician, the possible use of photography, and the need to individualize patient management.