Atypical Mole (Dysplastic Nevus) Treatment & Management

  • Author: Kimberly A Wenner, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 23, 2012
 

Medical Care

All patients diagnosed with 1 or more atypical mole (AM) should undergo a complete cutaneous examination. Patients should be taught self-examination to detect changes in existing moles and to recognize clinical features of melanomas. Several studies have shown that regular cutaneous examinations combined with baseline and serial color photographs of the patient's cutaneous surface ultimately decrease biopsies and lead to earlier diagnoses of melanoma.[29]

Patients with atypical moles should avoid all UV-emitting tanning devices, excessive sun exposure and routinely use a broad-spectrum sunscreen with a sun protective factor of 30 or greater.

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Surgical Care

Because melanomas may develop de novo on the skin and because the risk of any one atypical mole developing malignant transformation is low, the prophylactic removal of all atypical moles does not prevent the development of melanoma and is not recommended. Changing lesions and any lesion worrisome for melanoma must be removed.

A narrow-margin excisional biopsy or saucerization may be appropriate and can produce adequate tissue for histologic examination. If a suspicious mole is too large for simple excision and is in either a cosmetically sensitive location or a functionally sensitive location, a limited biopsy may be considered. However, because of sampling error, the diagnosis may be inaccurate.[33] To decrease the risk of an inaccurate diagnosis, obtaining more than 1 biopsy specimen should be considered, and each biopsy specimen should be full thickness for optimal microscopic evaluation. A wider excision may be indicated after histologic interpretation of the lesion.

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Consultations

Atypical moles are clinically challenging, and clinical experience with pigmented lesions is often necessary for proper diagnosis. Persons with unusual nevi, or many nevi, usually benefit from consultation with a dermatologist.

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Contributor Information and Disclosures
Author

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.

Coauthor(s)

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.

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 & 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, and United States and Canadian Academy of Pathology

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.

Specialty Editor Board

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, Medical Dermatology Society, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

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, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD  Herman Beerman Associate 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 and American Society of Dermatopathology

Disclosure: Lippincott Williams Wilkins Royalty Textbook editor; DLA Piper Consulting fee Consulting

Glen H Crawford, MD  Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital

Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

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

Disclosure: Nothing to disclose.

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