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Dermatopathology: Practical & Conceptual October - December 1996
Dysplastic Nevus:: National Institutes of Health Consensus Development Conferences, 1983 and 1992— Consensus?
Daniela Massi, MD
Timothy A. Nielsen, MD
A. Bernard Ackerman, MD
Key Questions Posed by the Organizers
“Dysplastic Nevus”: Clinical Aspects
“Dysplastic Nevus”: Histopathologic Aspects
“Dysplastic Nevus”: Cytologic Atypia
Prevalence of “Dysplastic Nevi”
“Dysplastic Nevus Syndrome”
Risk of Melanoma
Management of “Dysplastic Nevi”
1983 NIH Consensus Development Conference:
"Precursors to Malignant Melanoma"
1992 NIH Consensus Development Conference:
"Diagnosis and Treatment of Early Melanoma"
The Consensus Development Conference of 1983 focused on DN and congenital nevi as the prime "suspected precursors" of cutaneous melanoma. Proponents of the thesis of "precursors of melanoma" contended that identification of these lesions and proper management of them could reduce significantly the incidence of and mortality from melanoma. In actuality, however, about 80% of melanomas in Caucasians and nearly 100% of them in Asians, Africans, Afro-Americans, arise de novo, i.e., not in association with a pre-existing nevus of any kind. Because undue attention has been given to melanocytic nevi as precursors of melanoma, other factors that could contribute to enhanced risk for melanoma have been given short shrift.
Although the main topics of the Consensus Development Conference of 1992 were diagnosis and management of "early melanoma," one full day of the three-day conference was devoted entirely to the subject of DN.
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