Nevi, Melanocytic

Benign mole

• Small (< 6 mm) lesion with a well-defined border

• Single shade of pigment from beige or pink to dark brown

Stages of nevi

• First decade: junctional nevi are nevus cells are at the junction of the epidermis and dermis; appear as flat, small, brown lesions

• Over next 2 decades: Compound nevi are moles that have enlarged and become raised, reflecting appearance of a dermal component

• As white patients enter their eighth decade: most moles lose their junctional component and dark pigmentation

Normal moles should be well-demarcated, symmetric, and uniform in contour and color

May darken and grow during pregnancy

Physical examination must take precedence over the history

Benign nevi must be differentiated from malignant melanomas

Signs of melanoma can be remembered by the mnemonic: ABCDE with A = Asymmetry; B = Border irregularity; C = Color variegation; D = Diameter greater than 6 mm; E = Evolution

None required; benign moles have a normal natural history

Regular mole screening is not an evidence-based recommendation for all adults although rates of such screening continue to rise

Moles that are atypical in any fashion that suggests melanoma should be excised and submitted for pathologic examination