Dysplastic nevus: why this term should be abandoned in dermatoscopy

Area of Science:

• Dermatology
• Pathology
• Oncology

Background:

• The term "dysplastic nevus" implies histomorphology can predict the behavior of melanocytic proliferations.
• This concept is widely accepted but lacks robust supporting evidence.

Purpose of the Study:

• To critically evaluate the term "dysplastic nevus" and its underlying assumptions.
• To propose alternative diagnostic terminology for benign melanocytic proliferations.

Main Methods:

• Review of existing literature on melanocytic lesion diagnosis.
• Analysis of histomorphological and dermatoscopic findings in relation to clinical outcomes.
• Evaluation of the predictive value of current diagnostic criteria.

Main Results:

• Current evidence does not support the hypothesis that histomorphology accurately predicts the fate of benign melanocytic proliferations.
• Observations exist that contradict the predictive capabilities attributed to "dysplastic nevus" classification.
• Dermatoscopy offers patterns that can aid in specific diagnoses.

Conclusions:

• The term "dysplastic nevus" is a misnomer and should be abandoned.
• A specific diagnosis based on dermatoscopic patterns is preferred.
• When a specific diagnosis is not possible, "nevus, not otherwise specified" should be used based on clinical or dermatoscopic grounds.