title: The dermoscopic classification of atypical melanocytic naevi (Clark naevi) is useful to discriminate benign from malignant melanocytic lesions.
abstract: BACKGROUND
  The dermoscopic classification is a useful tool for handling patients with atypical naevi (Clark naevi).
  
  
  OBJECTIVE
  To investigate if the dermoscopic classification of atypical naevi is of any value to discriminate benign from malignant melanocytic lesions.
  
  
  METHODS
  Consecutive patients (n = 205) were included with 254 suspicious melanocytic lesions, confirmed by histopathology at the Pigmented Lesions Clinic of the Department of Dermatology, University Medical Center, University of Tuebingen, Germany. In this retrospective study, dermoscopic images of benign and malignant melanocytic lesions were classified according to the dermoscopic classification of atypical naevi (reticular, globular, homogeneous or combinations of two of these) and pigmentation (uniform, central hyper- or hypopigmentation, eccentric peripheral hyper- or hypopigmentation, or multifocal hyper- or hypopigmentation). The three-structure type (reticular, globular and homogeneous) was additionally defined.
  
  
  RESULTS
  Reticular, homogeneous and reticular-homogeneous types were significantly more frequent in naevi than in melanomas, whereas the three-structure type was significantly more frequent in melanomas (P < 0.001). A sensitivity of 86.7%, specificity of 87.7% and diagnostic accuracy of 87.4% was obtained. Uniformly pigmented and centrally hyperpigmented types were significantly more frequent in naevi than in melanomas, whereas eccentric peripheral hyperpigmented and multifocal hyper- or hypopigmented types were significantly more frequent in melanomas (P < 0.001).
  
  
  CONCLUSIONS
  The dermoscopic classification of atypical naevi (Clark naevi) is useful to discriminate benign from malignant melanocytic lesions. The three-structure type and eccentric peripheral hyperpigmentation were significantly more frequently found in malignant than in benign melanocytic lesions. The knowledge of these two dermoscopic types should be helpful for the management of patients presenting with multiple melanocytic lesions.
authors.affiliation: Department of Dermatology, University of Tuebingen, Liebermeisterstrasse 25, 72076 Tuebingen, Germany. a.blum@derma.de
authors.forename: A
authors.initials: A
authors.lastname: Blum
authors.forename: H P
authors.initials: HP
authors.lastname: Soyer
authors.forename: C
authors.initials: C
authors.lastname: Garbe
authors.forename: H
authors.initials: H
authors.lastname: Kerl
authors.forename: G
authors.initials: G
authors.lastname: Rassner
authors.forename: R
authors.initials: R
authors.lastname: Hofmann-Wellenhof
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000473:pathology*; D016017:Odds Ratio; D012189:Retrospective Studies; D012306:Risk; D012680:Sensitivity and Specificity; D012867:Skin / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology*; D012880:Skin Pigmentation