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Atypical Mole (Dysplastic Nevus) Follow-up

  • Author: Manuel Valdebran, MD; Chief Editor: Dirk M Elston, MD  more...
Updated: Jan 12, 2015

Further Outpatient Care

Patients with atypical moles (AMs) should be routinely monitored and have a complete cutaneous examination at least every 12 months. More frequent examinations may be indicated if compounding risk factors exist.[43] Atypical moles may change over time; however, melanocytic lesions that develop 1 or more of the following conditions may require immediate excision and histologic examination:

  • Sudden enlargement in size
  • Development of irregular or notched borders
  • Inflammation
  • Increase in pigmentation
  • Mottling of previously uniform pigment
  • Bleeding and/or ulceration
  • Symptoms of pain or pruritus


Currently, no therapy is available to prevent the development of atypical moles. Multiple studies are ongoing to evaluate therapies for eradication of atypical nevi and chemoprevention of progression to melanoma. Some of the treatments under study include imiquimod, retinoids, statin medications, and cyclooxygenase inhibitors.[44, 45]

Because sun exposure and UV light may modify the number, the appearance, and the progression of some cases of atypical mole, patients are encouraged to avoid the sun and to routinely use a broad-spectrum sunscreen with a sun protection factor of 30 or greater, in addition to avoiding UV tanning beds.



An individual with an isolated atypical mole has little risk of developing a melanoma and should not be identified as melanoma prone.

Patients with familial atypical mole and melanoma (FAMM) syndrome are at an increased risk for the development of a melanoma. The cumulative risk of melanoma in patients with FAMM syndrome may approach 100%. Furthermore, these patients are at an increased risk for the development of multiple, primary melanomas. The likelihood of a second melanoma developing over the course of 10 years may be as high as 35% in patients with FAMM syndrome, compared with 17% in controls who had an isolated sporadic melanoma. Melanomas that are detected early and removed quickly, because of proper and routine screening, tend to be thin, allowing for a good prognosis.

If a patient is diagnosed with FAMM syndrome, recommend that all first-degree relatives be examined. In 2009, selection criteria for genetic assessment of patients with familial melanoma were proposed to test for the CDK2NA mutation[46] :

  • Individuals with 3 or more primary invasive melanomas
  • Families with at least one invasive melanoma and 2 or more cases of melanoma and/or pancreatic cancer among first- or second-degree relatives on the same side of the family

Case reports suggest a possible association between uveal melanoma and patients with FAMM syndrome.[47] Baseline eye examination may be indicated in the workup of persons with FAMM syndrome.

A subset of FAMM syndrome kindreds will also have hereditary pancreatic cancer (FAMM-PC syndrome), also associated with the CDK2NA mutation, and screening for pancreatic cancer may be advisable in certain patients and families.[48]


Patient Education

Patients should be taught self-examination to detect changes in existing moles and to recognize the clinical features of melanoma. Patients should be advised to avoid the sun whenever possible and about adequate sun protection. Patients should be advised to avoid UV tanning beds.

For excellent patient education resources, see eMedicineHealth's patient education article Mole Removal.

Contributor Information and Disclosures

Manuel Valdebran, MD Visiting Dermatopathology Fellow, University of California, San Francisco, School of Medicine

Manuel Valdebran, MD is a member of the following medical societies: International Dermoscopy Society, Medical Dermatology Society, Society for Pediatric Dermatology

Disclosure: Nothing to disclose.


Vinod B Shidham, MD, FRCPath Professor, Vice-Chair-AP, and Director of Cytopathology, Department of Pathology, Wayne State University School of Medicine, Karmanos Cancer Center and Detroit Medical Center; Co-Editor-in-Chief and Executive Editor, CytoJournal

Vinod B Shidham, MD, FRCPath is a member of the following medical societies: American Association for Cancer Research, American Society of Cytopathology, College of American Pathologists, International Academy of Cytology, Royal College of Pathologists, United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD Herman Beerman Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System

Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, Pennsylvania Academy of Dermatology

Disclosure: Received royalty from Lippincott Williams Wilkins for textbook editor.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Robin Travers, MD Assistant Professor of Medicine (Dermatology), Dartmouth University School of Medicine; Staff Dermatologist, New England Baptist Hospital; Private Practice, SkinCare Physicians

Robin Travers, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Informatics Association, Massachusetts Medical Society, Women's Dermatologic Society, Medical Dermatology Society

Disclosure: Nothing to disclose.


Scott M Acker, MD Associate Professor, Director of Dermatopathology, Departments of Dermatology and Pathology, University of Alabama at Birmingham

Scott M Acker, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, American Society for Clinical Pathology, and Southern Medical Association

Disclosure: Nothing to disclose.

Steven Brett Sloan, MD Assistant Professor, Department of Dermatology, University of Connecticut School of Medicine; Residency Site Director, Connecticut Veterans Affairs Healthcare System; Volunteer Clinical Instructor, Yale University School of Medicine

Steven Brett Sloan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and Connecticut State Medical Society

Disclosure: Nothing to disclose.

Kimberly A Wenner, MD Assistant Chief of Dermatology, Madigan Army Medical Center

Kimberly A Wenner, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

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