How is a recurring dysplastic nevus different from a skin cancer?

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PeterBeitschMD (Physician - Surgery - Surgical Oncology (Verified) ) - 07 / 29 / 2012

Recurrent nevi (RN) are a vexing entity pathologically. Nevi can grow back from cells left behind after a shave biopsy. These cells although appearing 'normal' pathologically, are in an abnormal location and can be mistaken for a bland melanoma. The concept of the dysplastic nevus (DN) and its association with melanoma entered the literature around 1978 with the description by Clark et al of the familial B-K mole syndrome a concept subsequently clarified and expanded to include nonfamilial, sporadic cases. The first reported case of recurrent DN after inadequate shave excision further extended the RN spectrum. Nests of atypical melanocytes were present in the junctional component of the recurrent lesion, in association with a strikingly pigmented and densely cellular dermal infiltrate. The authors stressed that such cases were benign, while acknowledging that, in addition to the degree of junctional atypia expected in RN, additional atypia attributable to the original DN might further compound diagnostic difficulties. An additional challenge in the case of some recurrent DN was the dermal reaction to Monsel solution, which is used to control bleeding. Recurrent nevi have been shown to originate from DN in 20% to 28% of cases. Despite the pathologic challenges, recurrent dysplastic nevi are not a melanoma and do not turn into one.
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