A Clinical, Dermoscopic, and Histopathological Analysis of Common Acquired Melanocytic Nevi in Skin of Color.

Background: Acquired melanocytic nevi are very common and usually multiple. Corroborating clinical and dermoscopic diagnosis with histopathology will help in differentiating benign nevi from malignant and thus, obviate the need of biopsy in benign nevi. Additionally, it helps in predicting the chances of recurrence after removal leading to better treatment outcome and patient counselling. Objective: This study aimed to examine the clinical, dermoscopic, and histopathological features of common acquired melanocytic nevi. It also assessed the association between the two. Methods: One hundred Indian patients aged 18 years or older with clinical features suggestive of common acquired melanocytic nevi were enrolled in the study. The nevi were assessed clinically and dermoscopically using ABCD rule and if found benign, were excised using shave excision. The specimen obtained was sent for histopathological examination. Results: The age of the patients varied from 18 to 50 years with 83 females and 17 males. There was a 100 percent concordance rate between the clinical and histopathology diagnosis of intradermal nevi whereas higher discordance rate for that of compound nevi. Hair was present in a total 25 nevi and all were intradermal nevi on histopathology. Dermoscopy features suggestive of compound nevi were biaxial symmetry, presence of pigment network, and structureless homogenous areas. Features suggestive of intradermal nevi on dermoscopy were presence of blue-grey color, globules, structureless areas, and branched streaks. Conclusion: This is a pioneering study correlating the clinical and dermoscopic features with histopathology in skin of color. There is 100 percent concordance rate between clinical and histopathological diagnosis of intradermal nevi. Dermoscopy is a useful non-invasive tool for assessing the presence of certain dermoscopic features and predicting the type of nevi and their recurrences.