Melanocytic Nevi – Dysplastic Nevi

Dysplastic Nevi are one of the most common skin lesions I encounter in both my The Woodlands dermatology and Conroe dermatology offices.  Dysplastic Nevi are melanocytic nevi that usually have an atypical clinical appearance with multicoloration, irregular borders, and/or increasing size with atypical histological features.  Although Dysplastic Nevi are benign, they can be viewed as pre-malignant lesions and can elevate a patient’s risk of developing a melanoma either de novo or arising in a Dysplastic Nevus.  Dysplastic Nevi are typically graded mild, moderate or severe.  Severely Dysplastic Nevi are essentially “one step away” from melanoma.  In many cases, the biopsy of a Dysplastic Nevus can completely remove the lesion especially if the dermatologist takes a 2mm margin of normal appearing skin around the Dysplastic Nevus.  In cases where a Dysplastic Nevus has positive margins on biopsy, most dermatologists elect to excise the biopsy site with a 3-5mm margin.  As a severely Dysplastic Nevus is very close to a melanoma histologically, it is usually standard that a 5mm surgical margin is performed on a these Dysplastic Nevi even if clear margins were obtained on the biopsy.  Patients with a history of Dysplastic Nevi should have a skin exam by a board certified dermatologist every 6-12 months and should perform monthly self exams.