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November 2007

Dermoscopic Changes in Acral Melanocytic Nevi During Digital Follow-up

Author Affiliations

Author Affiliations: Department of Dermatology, University of L’Aquila, L’Aquila, Italy (Drs Altamura, Fargnoli, and Peris); Department of Dermatology, Medical University of Graz, Graz, Austria (Dr Zalaudek); Public Health Agency of Lazio Region, Rome, Italy (Dr Sera); and Department of Dermatology, Second University of Naples, Naples, Italy (Drs Argenziano and Rossiello).

Arch Dermatol. 2007;143(11):1372-1376. doi:10.1001/archderm.143.11.1372

Objective  To investigate changes in dermoscopic patterns of acquired acral melanocytic nevi (AAMN) over time.

Design  Retrospective analysis of digital dermoscopic follow-up of 230 AAMN located on acral volar skin.

Setting  Outpatient clinics at university dermatology departments.

Patients  A total of 230 AAMN located on the soles (n = 149), fingers (n = 62), and palms (n = 19), of 230 white subjects 14 years or younger (n = 81), 15 to 30 years (n = 72), and older than 30 years (n = 77).

Main Outcome Measure  Comparison of baseline and follow-up dermoscopic patterns.

Results  Individual AAMN had a digital follow-up of 6 months (n = 59), 12 months (n = 74), 18 months (n = 44), and 24 months (n = 53). Baseline dermoscopic images showed the following patterns: parallel furrow (48.8%), latticelike (16.1%), fibrillar (10.9%), nontypical (10.9%), homogeneous (4.8%), globular (3.5%), transition (3.5%), and reticular (2.6%). Dermoscopic changes over time were observed in 42 of the 230 AAMN (18.3%), with the greatest frequency of changes occurring in patients 14 years or younger (23 of 81 lesions; 28.4%) (P = .005). The parallel furrow pattern (25.9%) showed more variations over time than other dermoscopic patterns (11.0%) (P = .004). The frequency of change increased linearly over time (P = .001). Four of 7 clinically regressing nevi showed a homogeneous pattern at the last examination.

Conclusions  Dermoscopic changes of AAMN are most common in subjects younger than 14 years. The parallel furrow pattern appears to be the dermoscopic pattern most subject to change, while the homogeneous pattern may be seen also in AAMN showing clinical and dermoscopic involution.