DYSPLASTIC NEVI

General Information

DEFINITION--Nevi are skin lesions that often begin to grow in childhood (occasionally, they are congenital) and have appeared on the skin by early adult life. The most common types are freckles and common moles. Dysplastic nevi are a type that may continue to appear even after age 35. They are more suspect as precursors of melanomas (a serious type of skin cancer). Dysplastic nevus syndrome refers to the presence of multiple dysplastic nevi and melanoma in 2 or more first-degree family members.

BODY PARTS INVOLVED--Skin.

SEX OR AGE MOST AFFECTED--Both sexes; late teens and adults.

SIGNS & SYMPTOMS--

Lesions with the following characteristics:

• Borders are irregular and ill-defined.
• Have both flat and elevated areas.
• Measure 5-15mm in diameter (larger than common moles).
• Color ranges from tan to dark brown on a pink background.
• May appear anywhere on the body, but most frequently found on the back, chest, buttocks, breast and scalp. They are found in sun-exposed as well as sun-protected areas.
• Persons with dysplastic nevi may have about 100 lesions (most individuals have up to 15-20 common moles).

CAUSES--May be inherited or appear sporadically. Sunlight damage may play a part in distribution patterns of the nevi, but sun damage is not absolutely necessary, as the nevi appear on buttocks and female breasts, which are usually always covered.

RISK INCREASES WITH

• Family history of dysplastic nevi, melanomas or other skin cancers.
• Persons of northern European background (Celtic) with light colored hair and freckles.

HOW TO PREVENT

• Routine use of sunscreens. Use one with SPF of 15 or higher and that protects against ultraviolet A and ultraviolet B (most sunscreens protect against ultraviolet B only).
• If you have a family history of dysplastic nevi or skin cancer, get regular physical examinations to detect any new lesions or changes in existing ones. These may be as often as every 3 months for high-risk individuals. Also perform routine, self-examinations of your skin (see Skin Self Examination in Appendix) to determine any changes in individual lesions. Have a family member help check the areas of your body that are difficult for you to see.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Skin biopsy (See Glossary) of suspicious lesions.

APPROPRIATE HEALTH CARE

• Treatment may involve excision of suspicious lesions (those that have changed grossly), or excision of all lesions (even if there have been no changes in appearance).
• Color photographs may be taken of your body, so that on subsequent office visits, any changes can be verified.

POSSIBLE COMPLICATIONS--Melanoma, a possibly fatal form of skin cancer.

PROBABLE OUTCOME--The prognosis is good for those patients who have early diagnosis and treatment.

How To Treat

GENERAL MEASURES----Follow your doctor's instructions. Compliance with your medical treatment plan is essential for the best outcome.

MEDICATION--No medication is necessary for this disorder.

ACTIVITY--Be sure to use sunscreens and protective clothing for any exposure to the sun. Avoid sun exposure between 10 a.m. and 3 p.m. if possible.

DIET--No special diet.

Call Your Doctor If

• You have skin lesions (moles) that have changed in appearance.
• New lesions appear after treatment.