title: Using dermoscopic criteria and patient-related factors for the management of pigmented melanocytic nevi.
abstract: OBJECTIVE
  To review recent dermoscopy studies that provide new insights into the evolution of nevi and their patterns of pigmentation as they contribute to the diagnosis of nevi and the management of pigmented melanocytic nevi.
  
  
  METHODS
  Data for this article were identified by searching the English and German literature by Medline and Journals@Ovid search for the period 1950 to January 2009.
  
  
  METHODS
  The following relevant terms were used: dermoscopy, dermatoscopy, epiluminescence microscopy (ELM), surface microscopy, digital dermoscopy, digital dermatoscopy, digital epiluminescence microscopy, digital surface microscopy, melanocytic skin lesion, nevi, and pigmented skin lesions. There were no exclusion criteria.
  
  
  RESULTS
  The dermoscopic diagnosis of nevi relies on the following 4 criteria (each of which is characterized by 4 variables): (1) color (black, brown, gray, and blue); (2) pattern (globular, reticular, starburst, and homogeneous blue pattern); (3) pigment distribution (multifocal, central, eccentric, and uniform); and (4) special sites (face, acral areas, nail, and mucosa). In addition, the following 6 factors related to the patient might influence the pattern of pigmentation of the individual nevi: age, skin type, history of melanoma, UV exposure, pregnancy, and growth dynamics.
  
  
  CONCLUSIONS
  The 4 x 4 x 6 "rule" may help clinicians remember the basic dermoscopic criteria of nevi and the patient-related factors influencing their patterns. Dermoscopy is a useful technique for diagnosing melanocytic nevi, but the clinician should take additional factors into consideration to optimize the management of cases of pigmented lesions.
authors.affiliation: Medical University of Graz, Austria. iris.zalaudek@meduni-graz.at
authors.forename: Iris
authors.initials: I
authors.lastname: Zalaudek
authors.forename: Giovanni
authors.initials: G
authors.lastname: Docimo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Argenziano
mesh_terms: D046169:Dermoscopy; D006801:Humans; D009508:Nevus, Pigmented / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology*