Dysplastic Nevus Syndromes

Abstract

Dysplastic nevi (DMN) were first recognized as an autosomal dominant genetic marker of melanoma risk in hereditary cutaneous melanoma (HCMM) kindreds, families in which at least two melanomas have occurred. Subsequently, DMN have been identified in people with a personal but no family history of melanoma (SCMM), and with no history of melanoma. The lesions themselves may similarly be familial (FDMN) or sporadic (SDMN). A good deal is known about HCMM/FDMN kindreds and about patients with SCMM and DMN, while information about other subsets of DMN cases is slowly accumulating. Clinical evidence suggests that DMN may usually be familial when case‐finding is adequate.Although DMN are potential precursors of melanoma, the risk of progression of individual lesions is low, and their major significance is as markers of prospective risk for melanoma. This risk is heterogeneous, and there are important interactions with other risk factors, especially prior personal or familial melanoma. Traditional risk factors for melanoma, such as susceptibility to sunburn and ability to tan, may be expected to interact with the DMN trait to establish groups at heterogeneous risk. These groups may be regarded as syndromes of DMN cases, but to avoid confusion, it seems more appropriate to refer to cases by descriptive labels such as FDMN with HCMM, FDMN with personal CMM, FDMN without CMM, SDMN, and so on.