Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- presença desde o nascimento
- pápulas assimétricas, com bordas indistintas ou irregulares e de cores variadas com >5 mm de diâmetro
- história de alteração na forma e na cor
- assintomático (geralmente)
- lesões múltiplas
- mancha marrom plana
- pápula em forma de domo
- fundo marrom claro com pontos marrons mais escuros salpicados
- pápula em forma de domo cinza-azulada
- pápula central rosa a marrom com um anel branco despigmentado em volta
- pápula marrom rosada
Risk factors
- predisposição genética
- exposição à radiação ultravioleta
- pele clara
- idade: crianças mais velhas e adultos jovens
Diagnostic tests
1st tests to order
- dermatoscopia
Tests to consider
- tecnologias de imagem não invasivas
- fotografia de corpo inteiro
- biópsia
Emerging tests
- sequenciamento do genoma completo
- ensaio de lesão pigmentada (ELP)
Treatment algorithm
clinicamente benigno
suspeita clínica de melanoma
Contributors
Authors
Jason B. Lee, MD

Professor of Dermatology & Cutaneous Biology
Clinical Vice-Chair
Director of Dermatopathology Fellowship
Director of Pigmented Lesion Clinic
Thomas Jefferson University
Philadelphia
PA
Disclosures
JBL declares that he has no competing interests.
Acknowledgements
Dr Jason B. Lee would like to gratefully acknowledge Dr Laurel R. Schwartz, a previous contributor to this topic.
Disclosures
LRS declares that she has no competing interests.
Peer reviewers
Craig G. Burkhart, MD
Clinical Professor
Department of Medicine
Medical College of Ohio
Toledo
OH
Disclosures
CGB declares that he has no competing interests.
Mark Hurt, MD
Dermatologist
Cutaneous Pathology
WCP Laboratories
Missouri
MO
Disclosures
MH declares that he has no competing interests.
Veronique Bataille, MBBS
Consultant Dermatologist
West Herts NHS Trust and King's College London
London
UK
Disclosures
VB declares that she has no competing interests.
References
Key articles
Duffy K, Grossman D. The dysplastic nevus: from historical perspective to management in the modern era: part I. Historical, histologic, and clinical aspects. J Am Acad Dermatol. 2012 Jul;67(1):1.e1-16. Abstract
Duffy K, Grossman D. The dysplastic nevus: from historical perspective to management in the modern era. Part II. Molecular aspects and clinical management. J Am Acad Dermatol. 2012 Jul;67(1):19.e1-12. Abstract
Wernli KJ, Henrikson NB, Morrison CC, et al. Screening for skin cancer in adults: updated evidence report and systematic review for the US preventive services task force. JAMA. 2016 Jul 26;316(4):436-47.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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