This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on ISI (1)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Nevi  • Diagnosis  • Dermatology, Other  • Alert me on articles by topic

Iris Zalaudek, MD; Giuseppe Argenziano, MD; Ines Mordente, MD; Elvira Moscarella, MD; Rosamaria Corona, MD, DSc; Francesco Sera, Dstat; Andreas Blum, MD; Horacio Cabo, MD; Alessandro Di Stefani, MD; Rainer Hofmann-Wellenhof, MD; Robert Johr, MD; David Langford, MD; Josep Malvehy, MD; Isabel Kolm, MD; Anna Sgambato, MD; Susana Puig, MD; H. Peter Soyer, MD; Helmut Kerl, MD

Arch Dermatol. 2007;143(3):351-356.

Background  Dermoscopic classification of acquired melanocytic nevi (AMN) is based on the evaluation of 3 main criteria—global pattern, pigment distribution, and color.

Objective  To determine whether these features are different in AMN in white people with different skin types (STs) according to the Fitzpatrick classification.

Design  Digital dermoscopic images of AMN were evaluated, and the correlation of the 3 main dermoscopic criteria with patient ST was analyzed.

Setting  Consecutive patients were recruited from 7 pigmented lesion clinics between June 1, 2004, and June 30, 2005.

Patients  For each patient, the ST (I [always burns, never tans] to IV [rarely burns, tans with ease]) was scored, and 1 representative AMN (defined as the AMN showing a dermoscopic typology that is repeatedly seen in the same patient) was selected and photographed.

Main Outcome Measures  The distribution of the dermoscopic criteria of AMN in patients with different STs was calculated by univariate analysis. Differences in prevalence were tested using the ² test. The correlation between dermoscopic criteria and ST, adjusted for age, sex, and enrolling center, was evaluated by calculating odds ratios and 95% confidence intervals by logistic regression analysis.

Results  Of 680 included patients, dermoscopic analysis revealed significant differences in the prevalent nevus pattern in the 4 ST groups. Light brown AMN with central hypopigmentation were associated with ST I, and ST IV was associated with the so-called black nevus (P<.001), typified by reticular pattern, central hyperpigmentation, and dark brown coloration. A significant association was also found between multifocal pattern and ST II and ST III.

Conclusions  The dermoscopic nevus type varies according to different ST in white people. This knowledge may have an effect on obtaining for biopsy lesions that exhibit unusual dermoscopic patterns when patient ST is considered.

Author Affiliations: Department of Dermatology, Medical University of Graz, Graz, Austria (Drs Zalaudek, Di Stefani, Hofmann-Wellenhof, Soyer, and Kerl); Department of Dermatology, Second University of Naples, Naples, Italy (Drs Argenziano, Mordente, Moscarella, and Sgambato); Istituto Dermopatico dell’Immacolata (Dr Corona) and Public Health Agency of Lazio Region (Mr Sera), Rome, Italy; Instituto de Investigaciones Medicas, Universidad de Buenos Aires, Buenos Aires, Argentina (Dr Cabo); Pigmented Lesion Clinic, Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, Fla (Dr Johr); MoleCheck, Aikmans Road Clinic, Christchurch, New Zealand (Dr Langford); and Department of Dermatology, Melanoma Unit, Hospital Clinic, Institut de Investigacions Biomèdiques August Pi i Suñé, Barcelona, Spain (Drs Malvehy, Kolm, and Puig). Dr Blum is in private practice and privately teaches colleagues or residents in dermoscopy in Konstanz, Germany.