A Retrospective Study of 137 Dysplastic Nevi: Are a Personal History of Melanoma and Histopathological Factors Associated with High-grade Cytologic Atypia?

Aim: The association between the clinical and histopathological features of dysplastic nevi (DN), and the risk of melanoma is not clearly known. Thus, the aim of the present study is to determine if there is an association between the clinical and histopathological features of DN, and grade of cytologic atypia and personal history of melanoma (PHM).

Study Design: Retrospective clinicopathological study.

Place and Duration of Study: Departments of Dermatology and Pathology, Hacettepe University School of Medicine, between 2000 and 2010.

Methodology: The study included 137 DN in 85 patients. Clinical parameters, including age, gender, PHM and/or family history of melanoma, dysplastic naevus syndrome and lesion diameter and location, were retrospectively evaluated. Histopathological parameters, including presence of architectural changes, host response features were also evaluated, and cytologic atypia was graded as mild, moderate, or severe. Lastly, 2 DN subgroups were formed, as mild atypia and high-grade (moderate-severe) atypia. Statistical analysis was performed to identify any associations between atypia grade, and other DN features and PHM.

Results: Mean age of the patients was 32.49±13.02 years and the female-male ratio was 45/40. Most of the DN had moderate (49.6%) and mild atypia (39.4%), whereas severe atypia was observed in 10.9% of the lesions. DN with high-grade atypia were observed more frequently in the female patients (P = 0.042). Extremity localization, bridging and horizontal orientation of nests were more common in DN with high-grade atypia (P = 0.047, P = 0.006, P = 0.046, respectively). Furthermore, DN with high-grade atypia were associated with PHM, independent of all other factors (P = 0.026).

Conclusions: High-grade cytologic atypia in DN was associated with female gender, extremity location, bridging and horizontal orientation of nests, and PHM.