Pigmented Lesions: Clinical Pearls

Ashfaq Marghoob, MD

Dr Marghoob provides us with his clinical pearls on pigmented lesions….

1. The larger the congenital nevus the greater is the risk for developing melanoma.
2. The risk of a melanoma developing in a small congenital nevi is small enough that prophylactic excision is not required.
3. Presence of many nevi and dysplastic nevi are strong risk factors for melanoma.
4. Analytical, Differential and comparative recognition are all helpful in differentiating nevi from melanoma.
5. Total body photography assists clinicians in finding concerning lesions.
6. Dermoscopy assists clinicians in deciding which lesions require a biopsy.
7. Unna’s theory of nevogenesis is not supported by recent cross sectional and longitudinal studies.
8. Nevi with a peripheral globular pattern or a starburst pattern are growing nevi (not yet in senescence).
9. Most halo nevi have a globular pattern.
10. Patient driven healthcare with the use of Apps is likely to help in finding early melanomas.