Frequency and characteristics of enlarging common melanocytic nevi.
OBJECTIVE
To analyze the frequency and characteristics of enlarging common melanocytic nevi.


METHODS
Cohort study using digital epiluminescence microscopy (ELM) for documentation and follow-up, with a median follow-up interval of 11.4 months.


METHODS
A dermatology department at a university hospital in Vienna, Austria.


METHODS
One thousand six hundred twelve melanocytic nevi appearing clinically as common nevi, obtained from 385 patients (mean [+/-SD] age, 34.2 +/- 14.8 y; 55.6% female).


METHODS
Follow-up examination and documentation by digital ELM.


METHODS
Frequency of enlarging nevi according to age and comparison of ELM features observed in enlarging and nonenlarging nevi.


RESULTS
Enlargement was found in 5.3% (n = 86) of nevi. The frequency of enlarging nevi was inversely related to age (P<.001), in that enlarging nevi were common in patients younger than 20 years and relatively rare in older age groups. Epiluminescence microscopy revealed a peripheral rim of brown globules in 48.8% (n = 42) of enlarging nevi. In contrast, a peripheral rim of brown globules was found in only 0.7% (n = 11) of nevi without enlargement (P<.001). Enlarging nevi that were excised in children and adolescents showed no histological signs of atypia. In older age groups, 48.1% of excised enlarging nevi that were clinically diagnosed as common nevi showed some histological signs of atypia. None of the excised enlarging lesions was histologically diagnosed as melanoma.


CONCLUSIONS
The frequency of enlarging common nevi is inversely related to age. In the absence of clinical signs of atypia, enlargement alone does not indicate malignancy. A peripheral rim of brown globules is a characteristic ELM feature of symmetrically enlarging melanocytic nevi.
Kittler
H
H
Department of Dermatology, University of Vienna Medical School, Austria.
Seltenheim
M
M
Dawid
M
M
Pehamberger
H
H
Wolff
K
K
Binder
M
M
D000328:Adult; D017677:Age Distribution; D015331:Cohort Studies; D003936:Diagnosis, Computer-Assisted; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000453:epidemiology / Q000473:pathology*