Vulva
Premalignant lesions
Dysplastic nevi

Author: Sarah Strickland, M.D. (see Authors page)

Revised: 9 August 2016, last major update August 2016

Copyright: (c) 2002-2016, PathologyOutlines.com, Inc.

PubMed Search: Dysplastic nevi [title]

Essential Features
Terminology
  • Also called atypical nevus, nevus with architectural disorder, Clark’s nevus
Epidemiology
Sites
  • Any site; no predilection for anogenital skin
  • At sites with minimal sun exposure (breast, buttocks) and sun exposed areas
  • Genital lesions arise mainly on labia majora, labia minora, clitoris
  • May occur on perineum, pubic region, male genitalia
Clinical Features
Diagnosis
  • Biopsy / excision and histological examination
Prognostic Factors
Case Reports
Treatment
  • Excision
Clinical Images

Images hosted on other servers:

Examples of dysplastic nevi
defined based on clinical criteria



Images hosted on Nature servers:

Dysplastic nevus, clinical

Micro Description
  • Basilar proliferation of atypical melanocytes which must extend at least three rete ridges beyond the dermal component
  • Lentiginous or epithelioid cell pattern proliferation
  • Elongation and bridging of the rete ridges
  • Variable cellular atypia
  • Concentric eosinophilic or lamellar fibroplasia
  • Lymphocytic infiltrate
  • Vascular ectasia
Micro Images

Images hosted on other servers:

Low magnification micrograph of a dysplastic nevus

Intermediate magnification micrograph of a dysplastic nevus

High magnification micrograph of a dysplastic nevus



Images hosted on Nature servers:

Mild architectural and cytologic atypia

Moderate to severe architectural and cytologic atypia

Virtual Slides

Images hosted on other servers:

Dysplastic nevus
with severe cytologic
and architectural
atypic DD superficial
spreading melanoma

Dysplastic nevus
with slight cytologic
and architectural atypia

Dysplastic nevus
with inflammation
and regression

Positive Stains
Differential Diagnosis
  • Atypical melanocytic nevus of genital type:
    • Large, variably sized juncional nests with prominent retraction artifact or cellular dyscohesion
    • Nondescript pattern of dermal fibrosis
    • Underlying “mushroom shaped” dermal component with maturation
  • Melanoma:
    • Asymmetric
    • Irregular thickening and thinning of the epidermis
    • Uniform cytologic atypia
    • Increased pigment incontinence
    • Lack of maturation of cells in the dermis
    • Dermal mitotic figures
    • Pagetoid proliferation of melanocytes
Additional References