New insights into nevogenesis: in vivo characterization and follow-up of melanocytic nevi by reflectance confocal microscopy.
BACKGROUND
Development of melanocytic nevi is a complex process.


OBJECTIVE
The aim of the study was to characterize the in vivo confocal microscopy patterns and histopathologic correlates of melanocytic nevi. In addition, for the first time, confocal follow-up of characteristic nevi was performed documenting histologic changes in nevi.


METHODS
For the correlation study, 33 melanocytic nevi showing characteristic dermatoscopic patterns were studied by confocal microscopy. For the follow-up study 20 nevi were monitored for 12 to 18 months.


RESULTS
Reticular nevi showed two different confocal patterns, ringed and meshwork, mostly corresponding to lentiginous and nested junctional patterns, respectively. Globular nevi presented large junctional clusters, whereas cobblestone nevi were constituted by dermal dense melanocytic clusters. Homogeneous nevi did not show distinctive confocal and histopathologic findings. Nevi with a rim of globules presented a meshwork pattern with junctional clusters at the periphery. At the confocal follow-up study all lesions showed limited dynamic changes resulting in stable dermatoscopic and confocal patterns, but 3 globular nevi with junctional nests at baseline evolved into reticular-meshwork pattern nevi with peripheral rim of globules-junctional nests.


CONCLUSIONS
Longer confocal follow-up of more melanocytic nevi is required to confirm this theory and to validate our preliminary findings.


CONCLUSIONS
A model explaining the nevus classification and patterns of evolution of nevi observed in the study was proposed.
Pellacani
Giovanni
G
Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. pellacani.giovanni@unimore.it
Scope
Alon
A
Ferrari
Barbara
B
Pupelli
Gaia
G
Bassoli
Sara
S
Longo
Caterina
C
Cesinaro
Anna Maria
AM
Argenziano
Giuseppe
G
Hofmann-Wellenhof
Rainer
R
Malvehy
Josep
J
Marghoob
Ashfaq A
AA
Puig
Susana
S
Seidenari
Stefania
S
Soyer
H Peter
HP
Zalaudek
Iris
I
D000328:Adult; D046169:Dermoscopy; D005260:Female; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology*