Acquired melanocytic nevi (moles)
- Julie V Schaffer, MD
Julie V Schaffer, MD
- Attending in Pediatric Dermatology
- Director, Pediatric Dermatology Fellowship
- Division of Pediatric & Adolescent Dermatology
- Hackensack University Medical Center
- Jean L Bolognia, MD
Jean L Bolognia, MD
- Professor of Dermatology
- Yale University School of Medicine
- Section Editors
- Moise L Levy, MD
Moise L Levy, MD
- Section Editor — Pediatric Dermatology
- Professor of Pediatrics and Medicine (Dermatology)
- Dell Medical School, University of Texas, Austin
- Clinical Professor of Dermatology and Pediatrics
- Baylor College of Medicine
- Robert P Dellavalle, MD, PhD, MSPH
Robert P Dellavalle, MD, PhD, MSPH
- Section Editor — General Dermatology
- Professor of Dermatology and Public Health
- University of Colorado School of Medicine
- Colorado School of Public Health
- Chief, Dermatology Service
- US Department of Veterans Affairs
- Eastern Colorado Health Care System
- Hensin Tsao, MD, PhD
Hensin Tsao, MD, PhD
- Section Editor — Melanocytic Lesions and Disorders of Pigmentation
- Professor of Dermatology
- Harvard Medical School
Acquired melanocytic nevi will be discussed here. Congenital melanocytic nevi and other benign pigmented lesions are discussed separately. (See "Congenital melanocytic nevi" and "Benign pigmented skin lesions other than melanocytic nevi (moles)".)
Melanocytic nevi are benign proliferations of a type of melanocyte known as a "nevus cell." The two major differences between ordinary melanocytes that reside in the basal layer of the epidermis and nevus cells are:
●Nevus cells cluster as nests within the lower epidermis and/or dermis, whereas epidermal melanocytes are evenly dispersed as single units.
●Nevus cells do not have dendritic processes, except for those within blue nevi.
Both melanocytes and nevus cells can produce the pigment melanin. Melanocytic nevi may be congenital or acquired. Acquired nevi can be classified as common (banal) or atypical, and there are several additional variants, including halo nevi, blue nevi, and Spitz nevi.
- Orlow I, Satagopan JM, Berwick M, et al. Genetic factors associated with naevus count and dermoscopic patterns: preliminary results from the Study of Nevi in Children (SONIC). Br J Dermatol 2015; 172:1081.
- Dulon M, Weichenthal M, Blettner M, et al. Sun exposure and number of nevi in 5- to 6-year-old European children. J Clin Epidemiol 2002; 55:1075.
- Wiecker TS, Luther H, Buettner P, et al. Moderate sun exposure and nevus counts in parents are associated with development of melanocytic nevi in childhood: a risk factor study in 1,812 kindergarten children. Cancer 2003; 97:628.
- Harrison SL, MacLennan R, Buettner PG. Sun exposure and the incidence of melanocytic nevi in young Australian children. Cancer Epidemiol Biomarkers Prev 2008; 17:2318.
- Oliveria SA, Satagopan JM, Geller AC, et al. Study of Nevi in Children (SONIC): baseline findings and predictors of nevus count. Am J Epidemiol 2009; 169:41.
- Aalborg J, Morelli JG, Mokrohisky ST, et al. Tanning and increased nevus development in very-light-skinned children without red hair. Arch Dermatol 2009; 145:989.
- Gallagher RP, Rivers JK, Lee TK, et al. Broad-spectrum sunscreen use and the development of new nevi in white children: A randomized controlled trial. JAMA 2000; 283:2955.
- Autier P, Doré JF, Cattaruzza MS, et al. Sunscreen use, wearing clothes, and number of nevi in 6- to 7-year-old European children. European Organization for Research and Treatment of Cancer Melanoma Cooperative Group. J Natl Cancer Inst 1998; 90:1873.
- Luther H, Altmeyer P, Garbe C, et al. Increase of melanocytic nevus counts in children during 5 years of follow-up and analysis of associated factors. Arch Dermatol 1996; 132:1473.
- Garbe C, Büttner P, Weiss J, et al. Associated factors in the prevalence of more than 50 common melanocytic nevi, atypical melanocytic nevi, and actinic lentigines: multicenter case-control study of the Central Malignant Melanoma Registry of the German Dermatological Society. J Invest Dermatol 1994; 102:700.
- Schaffer JV. Update on melanocytic nevi in children. Clin Dermatol 2015; 33:368.
- Dellavalle RP, Johnson KR, Hester EJ, et al. Children with red hair have more freckles but fewer melanocytic nevi: results from a cohort study of 280 three-year-olds. Arch Dermatol 2005; 141:1042.
- Aalborg J, Morelli JG, Byers TE, et al. Effect of hair color and sun sensitivity on nevus counts in white children in Colorado. J Am Acad Dermatol 2010; 63:430.
- Harrison SL, Buettner PG, MacLennan R. Body-site distribution of melanocytic nevi in young Australian children. Arch Dermatol 1999; 135:47.
- De Giorgi V, Sestini S, Grazzini M, et al. Prevalence and distribution of melanocytic naevi on the scalp: a prospective study. Br J Dermatol 2010; 162:345.
- Coleman WP 3rd, Gately LE 3rd, Krementz AB, et al. Nevi, lentigines, and melanomas in blacks. Arch Dermatol 1980; 116:548.
- Martín RF, Sánchez JL, Vázquez-Botet M, Lugo A. Pigmented macules on palms and soles in Puerto Ricans. Int J Dermatol 1994; 33:418.
- Kogushi-Nishi H, Kawasaki J, Kageshita T, et al. The prevalence of melanocytic nevi on the soles in the Japanese population. J Am Acad Dermatol 2009; 60:767.
- Palicka GA, Rhodes AR. Acral melanocytic nevi: prevalence and distribution of gross morphologic features in white and black adults. Arch Dermatol 2010; 146:1085.
- Goettmann-Bonvallot S, André J, Belaich S. Longitudinal melanonychia in children: a clinical and histopathologic study of 40 cases. J Am Acad Dermatol 1999; 41:17.
- Buka R, Friedman KA, Phelps RG, et al. Childhood longitudinal melanonychia: case reports and review of the literature. Mt Sinai J Med 2001; 68:331.
- Siskind V, Darlington S, Green L, Green A. Evolution of melanocytic nevi on the faces and necks of adolescents: a 4 y longitudinal study. J Invest Dermatol 2002; 118:500.
- Scope A, Dusza SW, Marghoob AA, et al. Clinical and dermoscopic stability and volatility of melanocytic nevi in a population-based cohort of children in Framingham school system. J Invest Dermatol 2011; 131:1615.
- Scope A, Marchetti MA, Marghoob AA, et al. The study of nevi in children: Principles learned and implications for melanoma diagnosis. J Am Acad Dermatol 2016; 75:813.
- Fonseca M, Marchetti MA, Chung E, et al. Cross-sectional analysis of the dermoscopic patterns and structures of melanocytic naevi on the back and legs of adolescents. Br J Dermatol 2015; 173:1486.
- Marchetti MA, Kiuru MH, Busam KJ, et al. Melanocytic naevi with globular and reticular dermoscopic patterns display distinct BRAF V600E expression profiles and histopathological patterns. Br J Dermatol 2014; 171:1060.
- Bauer J, Garbe C. Acquired melanocytic nevi as risk factor for melanoma development. A comprehensive review of epidemiological data. Pigment Cell Res 2003; 16:297.
- NIH Consensus conference. Diagnosis and treatment of early melanoma. JAMA 1992; 268:1314.
- Slade J, Marghoob AA, Salopek TG, et al. Atypical mole syndrome: risk factor for cutaneous malignant melanoma and implications for management. J Am Acad Dermatol 1995; 32:479.
- Suh KY, Bolognia JL. Signature nevi. J Am Acad Dermatol 2009; 60:508.
- Grob JJ, Bonerandi JJ. The 'ugly duckling' sign: identification of the common characteristics of nevi in an individual as a basis for melanoma screening. Arch Dermatol 1998; 134:103.
- Kessides MC, Puttgen KB, Cohen BA. No biopsy needed for eclipse and cockade nevi found on the scalps of children. Arch Dermatol 2009; 145:1334.
- Zeff RA, Freitag A, Grin CM, Grant-Kels JM. The immune response in halo nevi. J Am Acad Dermatol 1997; 37:620.
- Kopf AW, Morrill SD, Silberberg I. Broad spectrum of leukoderma acquisitum centrifugum. Arch Dermatol 1965; 92:14.
- Rivers JK, MacLennan R, Kelly JW, et al. The eastern Australian childhood nevus study: prevalence of atypical nevi, congenital nevus-like nevi, and other pigmented lesions. J Am Acad Dermatol 1995; 32:957.
- Mooney MA, Barr RJ, Buxton MG. Halo nevus or halo phenomenon? A study of 142 cases. J Cutan Pathol 1995; 22:342.
- FRANK SB, COHEN HJ. THE HALO NEVUS. Arch Dermatol 1964; 89:367.
- Aouthmany M, Weinstein M, Zirwas MJ, Brodell RT. The natural history of halo nevi: a retrospective case series. J Am Acad Dermatol 2012; 67:582.
- Huynh PM, Lazova R, Bolognia JL. Unusual halo nevi--darkening rather than lightening of the central nevus. Dermatology 2001; 202:324.
- Lai C, Lockhart S, Mallory SB. Typical halo nevi in childhood: is a biopsy necessary? J Pediatr 2001; 138:283.
- González-Cámpora R, Galera-Davidson H, Vázquez-Ramírez FJ, Díaz-Cano S. Blue nevus: classical types and new related entities. A differential diagnostic review. Pathol Res Pract 1994; 190:627.
- Van Raamsdonk CD, Bezrookove V, Green G, et al. Frequent somatic mutations of GNAQ in uveal melanoma and blue naevi. Nature 2009; 457:599.
- Emley A, Nguyen LP, Yang S, Mahalingam M. Somatic mutations in GNAQ in amelanotic/hypomelanotic blue nevi. Hum Pathol 2011; 42:136.
- Carney JA, Gordon H, Carpenter PC, et al. The complex of myxomas, spotty pigmentation, and endocrine overactivity. Medicine (Baltimore) 1985; 64:270.
- Granter SR, McKee PH, Calonje E, et al. Melanoma associated with blue nevus and melanoma mimicking cellular blue nevus: a clinicopathologic study of 10 cases on the spectrum of so-called 'malignant blue nevus'. Am J Surg Pathol 2001; 25:316.
- Aloi F, Pich A, Pippione M. Malignant cellular blue nevus: a clinicopathological study of 6 cases. Dermatology 1996; 192:36.
- Busam KJ, Wanna M, Wiesner T. Multiple epithelioid Spitz nevi or tumors with loss of BAP1 expression: a clue to a hereditary tumor syndrome. JAMA Dermatol 2013; 149:335.
- Wiesner T, He J, Yelensky R, et al. Kinase fusions are frequent in Spitz tumours and spitzoid melanomas. Nat Commun 2014; 5:3116.
- Sau P, Graham JH, Helwig EB. Pigmented spindle cell nevus: a clinicopathologic analysis of ninety-five cases. J Am Acad Dermatol 1993; 28:565.
- Tlougan BE, Orlow SJ, Schaffer JV. Spitz nevi: beliefs, behaviors, and experiences of pediatric dermatologists. JAMA Dermatol 2013; 149:283.
- Argenziano G, Agozzino M, Bonifazi E, et al. Natural evolution of Spitz nevi. Dermatology 2011; 222:256.
- Scope A, Tabanelli M, Busam KJ, et al. Dispelling the myth of the "benign hair sign" for melanoma. J Am Acad Dermatol 2007; 56:413.
- Predisposing factors
- COMMON ACQUIRED MELANOCYTIC NEVI
- Clinical features
- - General features
- - Nevi on palms/soles
- - Nevi originating from the nail matrix
- Natural history
- ATYPICAL NEVI
- HALO NEVI
- Clinical features
- BLUE NEVI
- Clinical features
- Differential diagnosis
- SPITZ NEVI
- Clinical features
- BIOPSY CONSIDERATIONS
- Possible indications
- Other considerations
- SUMMARY AND RECOMMENDATIONS