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Rainer Hofmann-Wellenhof, MD; Andreas Blum, MD; Ingrid H. Wolf, MD; Domenico Piccolo, MD; Helmut Kerl, MD; Claus Garbe, MD; H. Peter Soyer, MD

Arch Dermatol. 2001;137:1575-1580.

Objectives  To create a dermoscopic classification of atypical melanocytic nevi (Clark nevi) and to investigate whether individuals bear a predominant type.

Design  Digital dermoscopic images of Clark nevi were classified according to structural features, ie, reticular, globular, or homogeneous patterns or combinations of these types. The nevi were also characterized as central hypopigmented or hyperpigmented, eccentric peripheral hypopigmented or hyperpigmented, or multifocal hypopigmented or hyperpigmented.

Setting  Two pigmented skin lesion clinics.

Patients  We examined 829 Clark nevi on 23 individuals.

Main Outcome Measure  A reliable dermoscopic classification of Clark nevi and frequency of different dermoscopic types.

Results  Using the dermoscopic classification, the 829 Clark nevi were classified as follows: 221 (26.7%) as reticular, 167 (20.1%) as reticular-homogeneous, 148 (17.9%) as globular-homogeneous, 112 (13.5%) as reticular-globular, 89 (10.7%) as homogeneous, 84 (10.1%) as globular, and 8 (1.0%) as unclassified. Most individuals were prone to a predominant type of Clark nevus. Seven individuals (30%) showed a single type of Clark nevus in more than 50% of their nevi and 5 (22%) in more than 40% of their nevi.

Conclusions  The proposed dermoscopic classification of Clark nevi is easily applicable and allows a detailed characterization of the different dermoscopic types of Clark nevi. Knowledge of these dermoscopic types should reduce unnecessary surgery for benign melanocytic lesions. Exact classification of the different types of Clark nevi is a necessary prerequisite for further clinical, dermoscopic, and histopathologic studies, which will give new insights in the biology of acquired melanocytic nevi.

From the Departments of Dermatology, University of Graz, Graz, Austria, (Drs Hofmann-Wellenhof, Wolf, Kerl, and Soyer), University of Tübingen, Tübingen, Germany (Drs Blum and Garbe), and University of L'Aquila, L'Aquila, Italy (Dr Piccolo).

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