Morphologic Changes of Acquired Melanocytic Nevi With Eccentric Foci of Hyperpigmentation (“Bolognia Sign”) Assessed by Dermoscopy

Pizzichetta, Maria Antonietta; Massone, Cesare; Grandi, G; Pelizzo, Gloria; Soyer, H. Peter

doi:10.1001/archderm.142.4.479

Cited by 27 publications

(18 citation statements)

References 15 publications

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“…), presenting at baseline with a mixed pattern typified by globules and dots, fragments of atypical pigment network, and structureless areas, showed a progressive increase in the number of brown dots and globules in the pigment network structures and structureless areas until it evolved into a common predominantly reticular nevus with some globules and dots. A similar observation was made in one child in whom an atypical nevus with eccentric foci of hyperpigmentation evolved into a common globular type of acquired melanocytic nevus .…”

Section: Discussionsupporting

confidence: 72%

Natural History of Atypical and Equivocal Melanocytic Lesions in Children: An Observational Study of 19 Cases

Pizzichetta

Talamini

Stanganelli

et al. 2014

Pediatric Dermatology

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Digital dermoscopy follow-up helps to identify patterns of change typical of common atypical nevi and early melanoma and improves the follow-up of patients with atypical nevi. We report the morphologic changes observed over time in 19 atypical or equivocal acquired melanocytic nevi that underwent dermoscopic follow-up. Two observers retrospectively examined digitalized dermoscopic images of 19 atypical melanocytic nevi from 15 children and young adults (median age 12 years, range 3-26 years). The images were assessed for global dermoscopic patterns at baseline and after a median 25-month (range 6-138 mos) follow-up. Ten (52.6%) nevi changed and nine (47.4%) retained a stable dermoscopic pattern. Of the 10 changing lesions, 2 of 4 homogeneous nevi evolved into a reticular pattern and 2 into a mixed pattern; 1 of 2 nevi with a mixed pattern evolved into a homogeneous nevus and 1 into a regressing nevus; 1 of 2 nevi with "other" patterns, such as negative pigment network and peppering throughout the lesion, evolved into a mixed nevus and 1 into a regressing nevus; 1 globular nevus evolved into a mixed pattern; and 1 starburst nevus evolved into a homogeneous nevus. The most striking results of our study were that atypical nevi can evolve into common nevi or they can regress, as documented by long-term dermoscopic follow-up. In children and young adults, dermoscopic follow-up of atypical nevi might be a valid alternative to surgical excision and enables us to achieve new insights into the natural history of these nevi.

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Section: Discussionsupporting

confidence: 72%

Natural History of Atypical and Equivocal Melanocytic Lesions in Children: An Observational Study of 19 Cases

Pizzichetta

Talamini

Stanganelli

et al. 2014

Pediatric Dermatology

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“…Another common reason for clinician concern is the presence of a ‘changing mole’ 21–24 . However, the approach to melanocytic naevi in children should differ from that in adults.…”

Section: Discussionmentioning

confidence: 99%

Excised melanocytic lesions in children and adolescents - a 10-year survey

Moscarella

Zalaudek

Cerroni

et al. 2012

British Journal of Dermatology

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Summary Background Early recognition and prompt excision is to date the only available strategy for reducing mortality from melanoma. Little is known about the accuracy of melanoma detection in children and adolescents. Objectives To assess the accuracy of melanoma detection in a paediatric population. Methods From the Department of Dermatology, Medical University of Graz, Austria, we reviewed the dermatopathology reports of naevi and melanomas excised in patients younger than 20 years over a 10‐year period (1998–2007). Patients were subdivided into four age groups: 0–4, 5–9, 10–14 and 15–19 years. Results Accuracy in melanoma detection was tested using the number needed to excise (NNE) value that is obtained by dividing the total number of excised lesions by the number of melanomas. A total of 22 564 lesions were reviewed, disclosing 22 526 naevi and 38 melanomas, for an overall NNE value of 593·8. Five melanomas were excised in children aged 10–14 years (NNE 1141) and 33 in children aged 15–19 years (NNE 479·8), whereas no melanomas were found among 1026 lesions excised in children younger than 10 years. In children aged 0–4 years, congenital and Spitz/Reed naevi accounted for 34·5% and 20% of lesions, respectively. These percentages decreased progressively when moving to older age groups (P < 0·0001). In contrast, the percentage of dermal and compound naevi rose in direct proportion with age, being 3·4% and 20·7%, respectively, in the youngest age group, and 36·7% and 31·9%, respectively, among the oldest patients (P < 0·0001). Conclusions The overall NNE value in paediatric patients over the 10‐year study period was 593·8, meaning that about 594 lesions were excised to find one melanoma. This value is 20 times higher than the rates found in adult patients.

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“…recently reviewed and reemphasized the melanoma risk of nevi with eccentric hyperpigmentation. 16 Studying reasons patients sought medical attention for pigmented lesions, Bränström et al . concluded one 'striking result' was that patients who had a melanoma often mentioned very dark lesions.…”

Section: Darkness and The Abcde Rulementioning

confidence: 99%