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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
Introduction
Title
Key Questions Posed by the Organizers
Recommended Terminology
“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”
Summary
References
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Prevalence of "Dysplastic Nevi"
1983 NIH Consensus Development Conference:
"Because the reported prevalence of individuals with dysplastic nevi is in the range of 2 to 8 percent, the impact of dysplastic nevi on the incidence of melanoma may be considerable."
1992 NIH Consensus Development Conference:
"The term "dysplastic nevus" has been used by various investigators in significantly different ways, thereby generating a great deal of controversy, and should be avoided. This confusion has resulted in a 10-fold difference in estimates of the frequency of these lesions."
Critique:
In 1989, Piepkorn maintained that as many as half of all Caucasians bear DN,20 which comports with the observation that the DN is the quintessential common acquired nevus. How seriously can figures like 2%, 8% and 50% be taken if none of those who spawned those numbers appreciate the fact that DN cannot be contrasted with CAN because DN are the commonest acquired nevi? In our judgment, the vast majority of Caucasians bear so-called DN.
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