Dysplastic nevus - Revision history

Michael at 14:02, 17 February 2016

2016-02-17T14:02:31Z

← Older revision		Revision as of 14:02, 17 February 2016
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	It is also known as '''atypical nevus''', '''dysplastic melanocytic nevus''', '''Clark nevus''', and '''nevus with architectural disorder'''.		It is also known as '''atypical nevus''', '''dysplastic melanocytic nevus''', '''Clark nevus''', and '''nevus with architectural disorder'''.

	In 1992, the term ''nevus with architectural disorder'' was recommended by the American National Institutes of Health (NIH);<ref name=pmid1515516>{{Cite journal \| title = Diagnosis and treatment of early melanoma. NIH Consensus Development Conference. January 27-29, 1992. \| journal = Consens Statement \| volume = 10 \| issue = 1 \| pages = 1-25 \| month = \| year = \| doi = \| PMID = 1515516 }}</ref> however, it is not widely adopted.<ref name=pmid22703907>{{Cite journal \| last1 = Elston \| first1 = D. \| title = Practical advice regarding problematic pigmented lesions. \| journal = J Am Acad Dermatol \| volume = 67 \| issue = 1 \| pages = 148-55 \| month = Jul \| year = 2012 \| doi = 10.1016/j.jaad.2012.04.006 \| PMID = 22703907 }}</ref> Also, based on 2003 survey, it is the preferred term by only 15% of dermatologists.<ref name=pmid14568850>{{Cite journal \| last1 = Fung \| first1 = MA. \| title = Terminology and management of dysplastic nevi: responses from 145 dermatologists. \| journal = Arch Dermatol \| volume = 139 \| issue = 10 \| pages = 1374-5 \| month = Oct \| year = 2003 \| doi = 10.1001/archderm.139.10.1374 \| PMID = 14568850 }}</ref>		In 1992, the term ''nevus with architectural disorder'' was recommended by the American National Institutes of Health (NIH);<ref name=pmid1515516>{{Cite journal \| title = Diagnosis and treatment of early melanoma. NIH Consensus Development Conference. January 27-29, 1992. \| journal = Consens Statement \| volume = 10 \| issue = 1 \| pages = 1-25 \| month = \| year = \| doi = \| PMID = 1515516 }}</ref> however, it is not widely adopted.<ref name=pmid22703907>{{Cite journal \| last1 = Elston \| first1 = D. \| title = Practical advice regarding problematic pigmented lesions. \| journal = J Am Acad Dermatol \| volume = 67 \| issue = 1 \| pages = 148-55 \| month = Jul \| year = 2012 \| doi = 10.1016/j.jaad.2012.04.006 \| PMID = 22703907 }}</ref> Also, based on a 2003 survey, it is the preferred term by only 15% of dermatologists.<ref name=pmid14568850>{{Cite journal \| last1 = Fung \| first1 = MA. \| title = Terminology and management of dysplastic nevi: responses from 145 dermatologists. \| journal = Arch Dermatol \| volume = 139 \| issue = 10 \| pages = 1374-5 \| month = Oct \| year = 2003 \| doi = 10.1001/archderm.139.10.1374 \| PMID = 14568850 }}</ref>

	==General==		==General==

Michael: tweak

2016-02-17T14:02:16Z

tweak

← Older revision		Revision as of 14:02, 17 February 2016
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	It is also known as '''atypical nevus''', '''dysplastic melanocytic nevus''', '''Clark nevus''', and '''nevus with architectural disorder'''.		It is also known as '''atypical nevus''', '''dysplastic melanocytic nevus''', '''Clark nevus''', and '''nevus with architectural disorder'''.

	In 1992, the term ''nevus with architectural disorder'' was recommended by the American National Institutes of Health (NIH);<ref name=pmid1515516>{{Cite journal \| title = Diagnosis and treatment of early melanoma. NIH Consensus Development Conference. January 27-29, 1992. \| journal = Consens Statement \| volume = 10 \| issue = 1 \| pages = 1-25 \| month = \| year = \| doi = \| PMID = 1515516 }}</ref> however, it is not widely adopted.<ref name=pmid22703907>{{Cite journal \| last1 = Elston \| first1 = D. \| title = Practical advice regarding problematic pigmented lesions. \| journal = J Am Acad Dermatol \| volume = 67 \| issue = 1 \| pages = 148-55 \| month = Jul \| year = 2012 \| doi = 10.1016/j.jaad.2012.04.006 \| PMID = 22703907 }}</ref> Also, it is the ~~prefered~~ term by only 15% of dermatologists.<ref name=pmid14568850>{{Cite journal \| last1 = Fung \| first1 = MA. \| title = Terminology and management of dysplastic nevi: responses from 145 dermatologists. \| journal = Arch Dermatol \| volume = 139 \| issue = 10 \| pages = 1374-5 \| month = Oct \| year = 2003 \| doi = 10.1001/archderm.139.10.1374 \| PMID = 14568850 }}</ref>		In 1992, the term ''nevus with architectural disorder'' was recommended by the American National Institutes of Health (NIH);<ref name=pmid1515516>{{Cite journal \| title = Diagnosis and treatment of early melanoma. NIH Consensus Development Conference. January 27-29, 1992. \| journal = Consens Statement \| volume = 10 \| issue = 1 \| pages = 1-25 \| month = \| year = \| doi = \| PMID = 1515516 }}</ref> however, it is not widely adopted.<ref name=pmid22703907>{{Cite journal \| last1 = Elston \| first1 = D. \| title = Practical advice regarding problematic pigmented lesions. \| journal = J Am Acad Dermatol \| volume = 67 \| issue = 1 \| pages = 148-55 \| month = Jul \| year = 2012 \| doi = 10.1016/j.jaad.2012.04.006 \| PMID = 22703907 }}</ref> Also, based on 2003 survey, it is the preferred term by only 15% of dermatologists.<ref name=pmid14568850>{{Cite journal \| last1 = Fung \| first1 = MA. \| title = Terminology and management of dysplastic nevi: responses from 145 dermatologists. \| journal = Arch Dermatol \| volume = 139 \| issue = 10 \| pages = 1374-5 \| month = Oct \| year = 2003 \| doi = 10.1001/archderm.139.10.1374 \| PMID = 14568850 }}</ref>

	==General==		==General==

Michael at 14:00, 17 February 2016

2016-02-17T14:00:59Z

← Older revision		Revision as of 14:00, 17 February 2016
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	It is also known as '''atypical nevus''', '''dysplastic melanocytic nevus''', '''Clark nevus''', and '''nevus with architectural disorder'''.		It is also known as '''atypical nevus''', '''dysplastic melanocytic nevus''', '''Clark nevus''', and '''nevus with architectural disorder'''.

	~~The~~ term ''nevus with architectural disorder'' is recommended by the American National Institutes of Health (NIH); however, it is not widely adopted.<ref name=pmid22703907>{{Cite journal \| last1 = Elston \| first1 = D. \| title = Practical advice regarding problematic pigmented lesions. \| journal = J Am Acad Dermatol \| volume = 67 \| issue = 1 \| pages = 148-55 \| month = Jul \| year = 2012 \| doi = 10.1016/j.jaad.2012.04.006 \| PMID = 22703907 }}</ref> Also, it is the prefered term by only 15% of dermatologists.<ref name=pmid14568850>{{Cite journal \| last1 = Fung \| first1 = MA. \| title = Terminology and management of dysplastic nevi: responses from 145 dermatologists. \| journal = Arch Dermatol \| volume = 139 \| issue = 10 \| pages = 1374-5 \| month = Oct \| year = 2003 \| doi = 10.1001/archderm.139.10.1374 \| PMID = 14568850 }}</ref>		In 1992, the term ''nevus with architectural disorder'' was recommended by the American National Institutes of Health (NIH);<ref name=pmid1515516>{{Cite journal \| title = Diagnosis and treatment of early melanoma. NIH Consensus Development Conference. January 27-29, 1992. \| journal = Consens Statement \| volume = 10 \| issue = 1 \| pages = 1-25 \| month = \| year = \| doi = \| PMID = 1515516 }}</ref> however, it is not widely adopted.<ref name=pmid22703907>{{Cite journal \| last1 = Elston \| first1 = D. \| title = Practical advice regarding problematic pigmented lesions. \| journal = J Am Acad Dermatol \| volume = 67 \| issue = 1 \| pages = 148-55 \| month = Jul \| year = 2012 \| doi = 10.1016/j.jaad.2012.04.006 \| PMID = 22703907 }}</ref> Also, it is the prefered term by only 15% of dermatologists.<ref name=pmid14568850>{{Cite journal \| last1 = Fung \| first1 = MA. \| title = Terminology and management of dysplastic nevi: responses from 145 dermatologists. \| journal = Arch Dermatol \| volume = 139 \| issue = 10 \| pages = 1374-5 \| month = Oct \| year = 2003 \| doi = 10.1001/archderm.139.10.1374 \| PMID = 14568850 }}</ref>

	==General==		==General==

Michael: /* Junctional */

2013-12-03T21:39:14Z

Junctional

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	<pre>		<pre>
	COMMENT:		COMMENT:
	Excision of ~~clinical~~ apparent residual components of the lesion~~, if present,~~		Excision of any clinically apparent residual components of the lesion
	is suggested.		is suggested.
	</pre>		</pre>

Michael: /* Junctional */

2013-12-03T21:36:10Z

Junctional

← Older revision		Revision as of 21:36, 3 December 2013
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	COMMENT:		COMMENT:
	Excision of clinical apparent residual components of the lesion, if present,		Excision of clinical apparent residual components of the lesion, if present,
	~~are~~ suggested.		is suggested.
	</pre>		</pre>

Michael: /* Sign out */

2013-12-03T21:34:13Z

Sign out

← Older revision		Revision as of 21:34, 3 December 2013
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	- DYSPLASTIC JUNCTIONAL MELANOCYTIC NEVUS WITH MILD NUCLEAR ATYPIA.		- DYSPLASTIC JUNCTIONAL MELANOCYTIC NEVUS WITH MILD NUCLEAR ATYPIA.
	- NEAREST MARGIN (LATERAL MARGIN) 1 MM.		- NEAREST MARGIN (LATERAL MARGIN) 1 MM.
			</pre>

			A comment for lesions with mild cytologic atypia:
			<pre>
			COMMENT:
			Excision of clinical apparent residual components of the lesion, if present,
			are suggested.
	</pre>		</pre>

Michael: /* Microscopic */

2013-11-14T03:12:17Z

Microscopic

← Older revision		Revision as of 03:12, 14 November 2013
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	**Joining of three or more adjacent rete ridges = suspicious for melanoma.<ref name=pmid15509670/>		**Joining of three or more adjacent rete ridges = suspicious for melanoma.<ref name=pmid15509670/>
	*Draping fibrous tissue - "lamellar fibrosis" - collagen deep to epidermis.		*Draping fibrous tissue - "lamellar fibrosis" - collagen deep to epidermis.
	*~~Usually~~ moderate ~~nuclear atypia~~ (small nucleoli ~~present~~) - see ''grading'' section.		*Nuclear atypia - often moderate (small nucleoli visible with 20x objective) - see ''grading'' section.
	*+/-Junctional component (cells in the epidermis at the DE junction) larger than the intradermal component - ''shoulder phenomenon''.		*+/-Junctional component (cells in the epidermis at the DE junction) larger than the intradermal component - ''shoulder phenomenon''.

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	**A two-tier grading system also exists (''low-grade'' (leave it alone) / ''high-grade'' (cut it out)).		**A two-tier grading system also exists (''low-grade'' (leave it alone) / ''high-grade'' (cut it out)).
	**Some pathologists do not grade dysplastic nevi.		**Some pathologists do not grade dysplastic nevi.
			*Normal melanocytes have a nucleus that is ~70% the size of a resting basal keratocyte nucleus.

	==Sign out==		==Sign out==

Michael: tweak

2013-11-13T09:34:25Z

tweak

Michael at 03:00, 13 November 2013

2013-11-13T03:00:29Z

← Older revision		Revision as of 03:00, 13 November 2013
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	\| Width =		\| Width =
	\| Caption = Dysplastic nevus. [[H&E stain]].		\| Caption = Dysplastic nevus. [[H&E stain]].
	\| Micro = ~~melanocytes~~ "bridges" between sides of rete ridges, draping fibrous tissue/fibrous tissue wraps around the rete ridges ("lamellar fibrosis"), nuclear atypia - see ''grading'' section, +/-junctional component (cells in the epidermis at the DE junction) larger than the intradermal component - ''shoulder phenomenon''		\| Micro = "bridges" between sides of rete ridges, draping fibrous tissue/fibrous tissue wraps around the rete ridges ("lamellar fibrosis"), nuclear atypia - see ''grading'' section, +/-junctional component (cells in the epidermis at the DE junction) larger than the intradermal component - ''shoulder phenomenon''
	\| Subtypes = junctional, compound		\| Subtypes = junctional, compound
	\| LMDDx = [[melanoma in situ]], [[malignant melanoma]], [[compound melanocytic nevus]], [[atypical lentiginous nevus]]		\| LMDDx = [[melanoma in situ]], [[malignant melanoma]], [[compound melanocytic nevus]], [[atypical lentiginous nevus]]

Michael: /* General */

2013-11-13T02:58:51Z

General

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	Treatment:		Treatment:
	*Dysplastic nevi with severe nuclear atypia are treated like melanoma - excision with a 5 mm margin.		*Dysplastic nevi with severe nuclear atypia are typically treated like [[melanoma in situ]] - complete excision with a 5 mm margin.<ref name=pmid15509670/>
	*Dysplastic nevi with moderate nuclear atypia with margin involvement are re-excised.<ref name=pmid15509670>{{Cite journal \| last1 = Culpepper \| first1 = KS. \| last2 = Granter \| first2 = SR. \| last3 = McKee \| first3 = PH. \| title = My approach to atypical melanocytic lesions. \| journal = J Clin Pathol \| volume = 57 \| issue = 11 \| pages = 1121-31 \| month = Nov \| year = 2004 \| doi = 10.1136/jcp.2003.008516 \| PMID = 15509670 }}</ref>		*Dysplastic nevi with moderate nuclear atypia with margin involvement are re-excised.<ref name=pmid15509670>{{Cite journal \| last1 = Culpepper \| first1 = KS. \| last2 = Granter \| first2 = SR. \| last3 = McKee \| first3 = PH. \| title = My approach to atypical melanocytic lesions. \| journal = J Clin Pathol \| volume = 57 \| issue = 11 \| pages = 1121-31 \| month = Nov \| year = 2004 \| doi = 10.1136/jcp.2003.008516 \| PMID = 15509670 }}</ref>

← Older revision		Revision as of 09:34, 13 November 2013
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	\| Width =		\| Width =
	\| Caption = Dysplastic nevus. [[H&E stain]].		\| Caption = Dysplastic nevus. [[H&E stain]].
	\| Micro = "bridges" between sides of rete ridges, draping fibrous tissue/fibrous tissue wraps around the rete ridges ("lamellar fibrosis"), nuclear atypia - see ''grading'' section, +/-junctional component (cells in the epidermis at the DE junction) larger than the intradermal component - ''shoulder phenomenon''		\| Micro = "bridges" between the sides of the rete ridges, draping fibrous tissue/fibrous tissue wraps around the rete ridges ("lamellar fibrosis"), nuclear atypia - see ''grading'' section, +/-junctional component (cells in the epidermis at the DE junction) larger than the intradermal component - ''shoulder phenomenon''
	\| Subtypes = junctional, compound		\| Subtypes = junctional, compound
	\| LMDDx = [[melanoma in situ]], [[malignant melanoma]], [[compound melanocytic nevus]], [[atypical lentiginous nevus]]		\| LMDDx = [[melanoma in situ]], [[malignant melanoma]], [[compound melanocytic nevus]], [[atypical lentiginous nevus]]
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	'''Dysplastic nevus''', abbreviated '''DN''', is a common [[melanocytic lesion]] that is closely associated with [[malignant melanoma]].		'''Dysplastic nevus''', abbreviated '''DN''', is a common [[melanocytic lesion]] that is closely associated with [[malignant melanoma]].

	It is also known as '''dysplastic melanocytic nevus''', '''Clark nevus''', and '''nevus with architectural disorder'''.		It is also known as '''atypical nevus''', '''dysplastic melanocytic nevus''', '''Clark nevus''', and '''nevus with architectural disorder'''.

	The term ''nevus with architectural disorder'' is recommended by the American National Institutes of Health (NIH); however, it is not widely adopted.<ref name=pmid22703907>{{Cite journal \| last1 = Elston \| first1 = D. \| title = Practical advice regarding problematic pigmented lesions. \| journal = J Am Acad Dermatol \| volume = 67 \| issue = 1 \| pages = 148-55 \| month = Jul \| year = 2012 \| doi = 10.1016/j.jaad.2012.04.006 \| PMID = 22703907 }}</ref> Also, it is the prefered term by only 15% of dermatologists.<ref name=pmid14568850>{{Cite journal \| last1 = Fung \| first1 = MA. \| title = Terminology and management of dysplastic nevi: responses from 145 dermatologists. \| journal = Arch Dermatol \| volume = 139 \| issue = 10 \| pages = 1374-5 \| month = Oct \| year = 2003 \| doi = 10.1001/archderm.139.10.1374 \| PMID = 14568850 }}</ref>		The term ''nevus with architectural disorder'' is recommended by the American National Institutes of Health (NIH); however, it is not widely adopted.<ref name=pmid22703907>{{Cite journal \| last1 = Elston \| first1 = D. \| title = Practical advice regarding problematic pigmented lesions. \| journal = J Am Acad Dermatol \| volume = 67 \| issue = 1 \| pages = 148-55 \| month = Jul \| year = 2012 \| doi = 10.1016/j.jaad.2012.04.006 \| PMID = 22703907 }}</ref> Also, it is the prefered term by only 15% of dermatologists.<ref name=pmid14568850>{{Cite journal \| last1 = Fung \| first1 = MA. \| title = Terminology and management of dysplastic nevi: responses from 145 dermatologists. \| journal = Arch Dermatol \| volume = 139 \| issue = 10 \| pages = 1374-5 \| month = Oct \| year = 2003 \| doi = 10.1001/archderm.139.10.1374 \| PMID = 14568850 }}</ref>
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	**Most melanoma cases do not have evidence of a pre-existing (dysplastic) nevus.<ref name=pmid21715047>{{Cite journal \| last1 = Longo \| first1 = C. \| last2 = Rito \| first2 = C. \| last3 = Beretti \| first3 = F. \| last4 = Cesinaro \| first4 = AM. \| last5 = Piñeiro-Maceira \| first5 = J. \| last6 = Seidenari \| first6 = S. \| last7 = Pellacani \| first7 = G. \| title = De novo melanoma and melanoma arising from pre-existing nevus: in vivo morphologic differences as evaluated by confocal microscopy. \| journal = J Am Acad Dermatol \| volume = 65 \| issue = 3 \| pages = 604-14 \| month = Sep \| year = 2011 \| doi = 10.1016/j.jaad.2010.10.035 \| PMID = 21715047 }}</ref>		**Most melanoma cases do not have evidence of a pre-existing (dysplastic) nevus.<ref name=pmid21715047>{{Cite journal \| last1 = Longo \| first1 = C. \| last2 = Rito \| first2 = C. \| last3 = Beretti \| first3 = F. \| last4 = Cesinaro \| first4 = AM. \| last5 = Piñeiro-Maceira \| first5 = J. \| last6 = Seidenari \| first6 = S. \| last7 = Pellacani \| first7 = G. \| title = De novo melanoma and melanoma arising from pre-existing nevus: in vivo morphologic differences as evaluated by confocal microscopy. \| journal = J Am Acad Dermatol \| volume = 65 \| issue = 3 \| pages = 604-14 \| month = Sep \| year = 2011 \| doi = 10.1016/j.jaad.2010.10.035 \| PMID = 21715047 }}</ref>
	*Large numbers of these nevi (10-100) are seen in ''dysplastic nevus syndrome''.<ref name=omim155600>{{OMIM\|155600}}</ref>		*Large numbers of these nevi (10-100) are seen in ''dysplastic nevus syndrome''.<ref name=omim155600>{{OMIM\|155600}}</ref>
	**Individuals with this syndrome have an increased risk of melanoma and approximately one third of their melanomas arise from a ''~~Clark~~ nevus''. The other two thirds arise ''de novo''.		**Individuals with this syndrome have an increased risk of melanoma and approximately one third of their melanomas arise from a ''dysplastic nevus''. The other two thirds arise ''de novo''.

	Clinical:<ref name=pmid22220461>{{Cite journal \| last1 = Dediol \| first1 = I. \| last2 = Bulat \| first2 = V. \| last3 = Zivković \| first3 = MV. \| last4 = Marković \| first4 = BM. \| last5 = Situm \| first5 = M. \| title = Dysplastic nevus--risk factor or disguise for melanoma. \| journal = Coll Antropol \| volume = 35 Suppl 2 \| issue = \| pages = 311-3 \| month = Sep \| year = 2011 \| doi = \| PMID = 22220461 }}</ref>		Clinical:<ref name=pmid22220461>{{Cite journal \| last1 = Dediol \| first1 = I. \| last2 = Bulat \| first2 = V. \| last3 = Zivković \| first3 = MV. \| last4 = Marković \| first4 = BM. \| last5 = Situm \| first5 = M. \| title = Dysplastic nevus--risk factor or disguise for melanoma. \| journal = Coll Antropol \| volume = 35 Suppl 2 \| issue = \| pages = 311-3 \| month = Sep \| year = 2011 \| doi = \| PMID = 22220461 }}</ref>