Dysplastic nevus physical examination
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The only way to diagnose dysplastic nevus is to remove tissue and check it for dysplasia.
Physical Examination and Diagnosis
- Asymmetry (one half of the lesion does not match the other in terms of shape or color).
- Notched, irregular, or ill-defined borders fading into surrounding skin
- Variegated color, with areas of pink, tan, brown, or dark brown.
- Diameter in one dimension >5 mm.
- Prominent macular component, sometimes with a papular center ("fried egg" or "target" appearance).
- Mammillated (cobblestone) topography.
Progression to melanoma most often manifests as a new focal area of deep pigmentation or firm elevation.
- In individuals with multiple nevi, the predominant group of nevi that share similar clinical and dermoscopic features defines the "signature nevus".
Ugly duckling" sign
- The identification of nevi that appear different from the signature nevi, called "ugly ducklings" or "outliers", has been suggested as a screening method for the detection of melanoma in patients with many nevi, including those with many atypical nevi
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