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Dermoscopic-Pathologic Correlates of Invasiveness and Nevus Visibility in Nevus-Associated Melanoma
Marco Spadafora1,2, Erica Baschieri3, Simonetta Piana4
1Department of Surgery, Medicine, Dental Medicine and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Experimental Dermatology
|July 30, 2026
Summary
Nevus-associated melanoma (NAM) visibility on dermoscopy depends on nevus size and depth. Melanoma features like ulceration can obscure the nevus, highlighting the need for prompt management based on invasive markers.
Area of Science:
- Dermatology
- Oncology
- Pathology
Background:
- Nevus-associated melanoma (NAM) presents with both nevus and melanoma components.
- The nevus component in NAM is often not visible during dermoscopic examination.
- Understanding factors influencing nevus visibility is crucial for accurate diagnosis.
Purpose of the Study:
- To investigate the histopathological determinants of nevus visibility in NAM.
- To identify dermoscopic features associated with invasive versus in situ NAM.
- To evaluate the relationship between nevus characteristics and dermoscopic appearance in NAM.
Main Methods:
- Retrospective observational study of 340 histologically diagnosed NAMs (2011-2024).
- Independent assessment of dermoscopic images by two readers.
- Systematic revision of histopathology to quantify nevus proportion, size, and depth.
Main Results:
- Nevus component was dermoscopically visible in 45.6% of NAMs.
- Larger nevus size (≥2.1 mm) and superficial location increased visibility; deep location and ulceration decreased visibility.
- Invasive NAM was associated with visible nevus component, shiny white structures, negative pigment network, and blue-white veil.
- Ulceration and deep nevus location obscured the nevus component.
Conclusions:
- Dermoscopic nevus visibility in NAM is primarily influenced by nevus size and depth.
- Melanoma-related changes, especially ulceration, can mask the associated nevus.
- Dermoscopic indicators of invasiveness warrant prompt management, even if a nevus component is suspected but not clearly visible.
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