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May 13, 2013 / molehunter

Some harmless naevi on my back

My wife took these images, I post them as examples of mildly asymmetrical naevi which taken as a whole amount to nothing really.

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reticular naevus, light brown. Few hypopigmented patches in top right quadrant, a bit lighter shade of brown in bottom left third, but not enough to be concerned.

8 B

Slight asymmetry and a few unremarkable dots and slightly abnormal pigment network in upper third, but again not enough to be excited about given no history of change and that the individual (me) has dozens of naevi looking quite similar, none of which stand out. This might just be a mildly dysplastic naevus but there is not enough suspicion, in my opinion, to justify excision unless there were a clear history of recent change. The most I would do (and indeed have done) is photograph and keep an eye on now and then looking out for change. NB dysplastic naevi are diagnosed on histopathology, and are not premalignant, although the individual with many clinically dysplastic naevi is at higher risk of a melanoma-which may equally come from clear skin as from a funny looking mole.

8 C

As normal a naevus as you will ever see. Excellent symmetry in vertical and horizontal planes, amorphous centre and reticular periphery. No atypical features.

8 D

reticular naevus with hypopigmented centre. Yes, this is slightly off centre but still counts as central hypopigmentation.

The point of these 4 images is that 3 of them show minor but similar degrees of geometric asymmetry, as do the other naevi on (my) back. There is no colour other than light/medium brown, none in my view contains any worrying features. Please check the melanoma images here and elsewhere for some compare and contrast. The learner in dermoscopy should study as many bland naevi as possible to develop an idea of the range of normal and how much asymmetry can be accepted.

PS I can’t prove beyond doubt these or any other naevi are normal without cutting them out, but based on extensive clinical experience and learning from many experts (including those I have linked to on the blogroll, whom I encourage you to check out) I have no reason to be suspicious. According to Professor Argenziano, only about 1 in 35,000 naevi will become malignant. The dermoscopist must learn to accept a degree of asymmetry, while of course always advising the patient to report any change. None of the above naevi were changing.

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  1. source / Mar 27 2014 4:41 am

    As in letter writing, notes cause impressions to be formed about one. An online writer must keep to the number 1 rule for all writers.

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