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Dermoscopy

Dermascopy | Goodman Dermatology | Roswell, GADermoscopy is a noninvasive method that allows the evaluation of colors and microstructures of the deeper layers of the skin not visible to the naked eye. The identification of specific diagnostic patterns related to the distribution of colors and dermoscopy structures can better suggest a malignant or benign pigmented skin lesion. The use of this technique provides a valuable aid in diagnosing pigmented skin lesions.

Dysplastic Nevus (Atypical Mole) may be your diagnosis.

A mole is a group of melanocytes (pigment-making cells) in the skin. Moles begin to arise in the first few months or years of life, and can increase in number with sun exposure. Most moles are the common variant which pose no risk. These are typically brown, pink, or flesh-colored, and round and regular in shape.

A dysplastic nevus is an atypical mole. While benign, these nevi are usually larger, with atypical features such as darker pigmentation, irregular pigmentation, and ill-defined borders. They occur most often on the trunk, arms and legs, and are less common on the face.

There is some controversy over the potential for a dysplastic nevus to become melanoma (Melanoma comes from skin cells called melanocytes, which create pigment called melanin that gives skin its color. 5% of all skin cancers are melanoma. Although less common, it is a very dangerous type of skin cancer and is the leading cause of death from skin disease). While it has been observed that a dysplatic mole can become melanoma, patients with numerous dysplastic nevi usually develop new melanomas from areas of normal-appearing skin, and in a higher percentage of patients than in those without dysplastic nevi. Therefore, it is thought that the presence of many dysplastic nevi is a “marker” for patients who have a higher chance of developing melanoma.

When a dermatologist finds a suspicious or atypical nevus on a skin examination by use of dermoscopy, the diagnosis is confirmed with a skin biopsy. The biopsy specimen is then evaluated by a dermatopathologist under the microscope, and a diagnosis is given. A mole is graded by the atypia (disorder of arrangement and appearance) of the nevus cells. A dysplastic nevus may be called mildly, moderately, or severely dysplastic.

Mildly dysplastic nevus – Common finding which usually requires no further treatment, but should be watched for future growth.

Moderately dysplastic nevus – Usually requires a larger excision or close observation of the area

Severely dysplastic nevus – Often a nevus with severe dysplasia may be difficult to differentiate from melanoma and a surgical excision is recommended.

Treatment of a dysplastic nevus is surgical. Standard excision with narrow margins 2-3 millimeters of normal skin is usually advised. Severely dysplastic nevi may require 5mm margins.