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Dermatoscopy of nevus cell nevi

With the aid of a dermatoscope, a so-called reflected-light microscope, skin lesions can be magnified and viewed in greater detail. This is usually done at 10x magnification of the skin finding. In dermoscopy, not only nevus cell nevi but also various other skin findings can be assessed and diagnosed. These include, for example, scabies, lichen ruber planus or seborrheic keratoses.

What are nevus cell nevi?

Nevus cell nevi are benign, melanocytic skin tumours. The number of moles increases steadily until the 3rd decade of life, with genetic predispositions and UV exposures playing a major role. Acquired nevi are well circumscribed, round to oval, with regular diameter of 2-5mm.

Depending on their location, three types are distinguished. Junctional nevus is located epidermally and usually has a solid medium to dark brown coloration. The compound nevus is located epidermodermally and is lighter pigmented than the junctional nevus.

And last but not least, the dermal nevus, which is located exclusively dermally, is usually raised and has a lighter coloration than the compund nevus.

Diagnosis of nevus cell nevi

Dermoscopy is used for the diagnosis and evaluation of skin tumour and nevi. Skin tumours include benign and malignant neoplasms characterized by autonomous growth. Nevi, on the other hand, are characterized by malformation with abnormal tissue composition and enlarge according to body growth.

Reliable assessment of the skin lesion is crucial for timely detection of malignant skin tumours. The most dangerous is malignant melanoma also known as black skin cancer, whereas tumours known as white skin cancer are much more common.

Evaluation by dermatoscope

Evaluation of a nevus cell nevus is performed during inspection with a dermoscope using the ABCDE rule. A malignant skin lesion should be suspected if A= asymmetric changes, B= border is irregular, C= colorite is irregular, D= diameter over 5mm, and E= elevation above the skin level.

These atypical changes are seen in dysplastic nevi, which are markers for the development of malignant melanoma. These nevi typically have a diameter of 5-15mm, are indistinctly circumscribed and variably pigmented. Their localization is usually on the trunk.

Conclusion

Patients with many nevi should undergo annual follow-up, and if there is evidence of atypical changes, these nevi should always be excised and examined histologically.

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Bibliography

  1. Thieme Kurzlehrbuch Dermatologie, 2. Auflage, Wolfram Sterry, 2011