Age- and Site-Specific Variation in the Dermoscopic Patterns of Congenital Melanocytic Nevi: An Aid to Accurate Classification and Assessment of Melanocytic Nevi | Congenital Defects | JAMA Dermatology | JAMA Network
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August 2007

Age- and Site-Specific Variation in the Dermoscopic Patterns of Congenital Melanocytic Nevi: An Aid to Accurate Classification and Assessment of Melanocytic Nevi

Author Affiliations

Author Affiliations: Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York (Drs Changchien, Agero, Halpern, and Marghoob and Mr Dusza); Department of Dermatology, State University of New York at Stony Brook Health Sciences Center, Stony Brook (Dr Korzenko); Department of Dermatology, University Hospital Geneva, Geneva, Switzerland (Dr Braun); Department of Dermatology, University of Michigan, Ann Arbor (Dr Sachs); and Department of Internal Medicine, Mercy Fitzgerald Hospital, Darby, Pennsylvania (Dr Usman). Dr Braun is now with the Dermatology Clinic, University Hospital Zürich, Zürich, Switzerland.

Arch Dermatol. 2007;143(8):1007-1014. doi:10.1001/archderm.143.8.1007

Objectives  To describe the dermoscopic features of congenital melanocytic nevi (CMN) and assess whether predominant dermoscopic patterns present in CMN are related to an individual's age (<12 years vs ≥12 years), sex, or lesional site (head, neck, and trunk vs extremities).

Design  Nonrandomized observational study.

Patients  A total of 77 consecutive patients, each with 1 CMN (n = 77 lesions), from an outpatient dermatology clinic. A diagnosis of CMN was established by (1) documentation of a melanocytic nevus during the first year of life or (2) by clinical examination and either clinical history or biopsy findings.

Main Outcome Measures  Images of CMN were evaluated for specific dermoscopic structures and patterns. The distribution of patterns was assessed by age, sex, and lesional site.

Results  Most of the 77 lesions exhibited 1 of the following predominant dermoscopic patterns: reticular (18 lesions [23%]), globular (14 [18%]), or reticuloglobular (12 [16%]). Globular CMN were present in 5 of the 19 individuals who were younger than 12 years (26%) but in only 9 of the 58 individuals 12 years or older (16%). Reticular CMN were seen exclusively in the individuals who were 12 years or older. Congenital melanocytic nevi exhibiting no predominant pattern were more commonly present in the individuals younger than 12 years. Globular CMN were present in 11 head, neck, and trunk lesions (30%) compared with 3 extremity lesions (8%). Conversely, reticular CMN were present in 16 extremity lesions (40%) compared with 2 head, neck, and trunk lesions (5%). The predominant dermoscopic pattern did not vary based on sex. The most commonly observed dermoscopic structures were globules (in 64 lesions [83%]), hypertrichosis (in 61 [79%]), and reticular networks (in 55 [71%]).

Conclusions  Our results suggest that the predominant dermoscopic patterns of CMN vary according to age and lesional site. These differences may inform future studies on the pathogenesis of CMN.