[Skip to Content]
[Skip to Content Landing]
April 13, 1984

Precursors to Malignant Melanoma: Congenital and Dysplastic Nevi

Author Affiliations

Beth Israel Hospital Harvard Medical School Boston

JAMA. 1984;251(14):1882-1883. doi:10.1001/jama.1984.03340380064029

It has become evident during the past few years that there are two types of nevi that are predisposed to develop cutaneous melanoma. The incidence of malignant melanoma has been rising over the past decade. It is now clear that conservative excision is curative for virtually all thin tumors. Precursor lesions—congenital and dysplastic nevi—and most melanomas can be detected by careful inspection of the skin. Identification and appropriate treatment of such atypical melanocytic lesions are tantamount to saving a patient's life, for aside from surgery, no other effective therapy exists. The physical examination of all patients should include evaluation of their entire cutaneous surface for unusual pigmented areas. Evaluation for melanoma or precursors will often include biopsy or excision or, if the lesion is to be reassessed periodically, a photograph to document its appearance. The Figures presented here and the accompanying National Institutes of Health consensus statement will guide clinicians

Clark WH, Reimer RR, Greene MH, et al:  Origin of familial malignant melanoma from heritable melanocytic lesions: The BK mole syndrome .  Arch Dermatol 1978;114:732-738.Crossref
Greene MH, Clark WH, Tucker MA, et al:  Precursor naevi in cutaneous malignant melanoma: A proposed classification .  Lancet 1980;2:1024.Crossref
Rhodes AR, Sober AJ, Day CL, et al:  The malignant potential of small congenital nevocellular nevi .  J Am Acad Dermatol 1982;6:230-241.Crossref
Rhodes AR:  Pigmented birthmarks and precursor melanocytic lesions of cutaneous melanoma identifiable in childhood .  Pediatr Clin North Am 1983;30:435-463.