Case Number : Case 3079 - 22 April 2022 Posted By: Dr. Richard Carr

An irritated dysplastic nevus, low grade (mild) atypia. clinical appearance is more or less stable, (limited by resolution of 2015 image)

I thought is dysplasia nevus too..

Lentiginous junctional growth pattern, concentric lamellar fibrosis around rete ridge and atypical cells with superficial mitosis, but in a random distribution, of intraepidermal melanocytes. So agree with Colleagues. The sovrapapillary epidermal plate is often free, or am’I wrong?

I also favour dysplastic nevus

I think its a dysplastic nevus. I see parakeratosis probably indicative of irritation?

I agree this is a dysplastic naevus (but with only mild atypia) - ?should be called just naevus according to WHO 4th but was the one removed as being clinically atypical. I've tended to to continue to report them as dysplastic naevus with mild atypia (rather than adopting low-grade = moderate atypia). I would worry about lesions with more severe atypia and ensure they were completely excised. We're lucky in the UK as we don't get the partial shave specimens that are common in the U.S. which must be very frustrating. I doubt the moderate atypia is all that reproducible and I've heard stories of lesions recurring occasionally as high grade lesions. Nice that PRAME was negative in this one but would not necessarily do it routinely in such a banal lesion providing it was fully excised.