What are the other Names for this Condition? (Also known as/Synonyms)

• Clark’s Nevus
• Dysplastic Naevus
• Dysplastic Nevus

What is Dysplastic Mole? (Definition/Background Information)

• A nevus (plural nevi) is a non-cancerous mole on the skin that can occur on any part of the body
• A Dysplastic Mole is an atypical mole/nevus with abnormal shape, borders, or color. While most nevi never become cancerous, a small number of Dysplastic Moles may develop into melanoma
• Dysplastic Moles arise from common moles that are either acquired (called acquired melanocytic nevi) or congenital (congenital moles). These moles can be of two types:
  • Junctional Dysplastic Mole
  • Compound Dysplastic Moles
• The greater the number of moles present in the body, the higher is the risk for Dysplastic Moles and thus of melanoma (a malignant skin cancer)
• Common moles may be present in all individuals including children and adults. The condition is more common in fair-skinned individuals than dark-skinned individuals
• Sun exposure and poor immunity are other risk factors for acquiring the condition. However, the cause of the condition is generally unknown. Research studies have implicated certain genetic mutations as being the probable cause
• The treatment of Dysplastic Moles generally involves surgery. The prognosis is generally excellent with treatment, as long as no transformation into a melanoma has occurred

Who gets Dysplastic Mole? (Age and Sex Distribution)

• Dysplastic Mole/Nevus is a common condition that may develop at any age in an individual; children and adults may have this type of mole
• Both males and females are affected and there is no gender bias observed
• All racial and ethnic groups are at risk, but this nevus type is more frequent in fair-skinned individuals (Caucasians)

What are the Risk Factors for Dysplastic Mole? (Predisposing Factors)

The risk factors identified for Dysplastic Moles include:

• Advancing age
• Exposure to ultraviolet (UV) rays is a major risk factor. UV rays are present in sunlight and also in tanning lamps and beds
• Generally, lighter-skinned races or individuals (such as Caucasians of America and Europe) are at a higher risk compared to other darker-skinned racial groups (such as Africans and Asians)
• The higher the number of moles an individual has, the greater are the chances of Dysplastic Mole formation: These moles can become dysplastic and transform into melanomas with time, in some individuals
• Family history of the condition
• Previous history of melanoma or a history of melanoma in parents/siblings
• An inherited condition called xeroderma pigmentosum, where the ability of the cells to repair sun-induced damage to genetic material is impaired
• Weakened immune system, as a result of infections, drugs (such as immunosuppressants), and cancers

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Dysplastic Mole? (Etiology)

• The cause of formation of a Dysplastic Mole is unknown in a majority of cases. In some cases, certain gene mutations have been documented
• Most cases occur sporadically, meaning in a random manner (termed sporadic, non-familial nevus). However, it can run in families too (termed familial nevus)

What are the Signs and Symptoms of Dysplastic Mole?

Dysplastic Moles develop from common moles that are normally well-circumscribed, round or oval in shape, uniformly pigmented papules, macules, or nodules. The signs and symptoms of Dysplastic Mole that may be observed include:

• It is a rapidly-growing mole with irregular borders
• Itching that is getting worse, and bleeding and ulceration
• The color over the mole may be irregular with some lighter and darker pigmented areas, which is an indication that the mole is turning into a Dysplastic Mole or a melanoma. In such cases, one should contact the healthcare provider right away
• They may be single or many in numbers; on an average, a Caucasian adult may have about 20 moles
• Dysplastic Moles can occur anywhere in the body and may be single or multiple

The ABCDE mnemonic is used frequently:

• A = Asymmetric, as in lacking symmetry from side to side
• B = Border, as in having a border which bays and inlets, not a smooth arc
• C = Color, as having several different hues of tan, brown, pink, or almost black
• D = Diameter, greater than 6 mm, the size of a common pencil eraser
• E = Evolution, as in growing in size, irregularity or borders, or changing colors notably over time

Common moles may become smaller and even disappear in some cases, when one reaches an older age. However, it is important to note that if the mole becomes a Dysplastic Mole, it does not become smaller and disappear with time. Hence, a Dysplastic Mole has to be observed carefully, since there is an increased risk for such a mole turning into a melanoma.

How is Dysplastic Mole Diagnosed?

A Dysplastic Mole is diagnosed through the following tools:

• Complete physical examination with evaluation of medical history: A whole body physical exam has to be performed, since some moles are not in direct visible sight
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Serial photographs can help one record a changing mole over time
• Skin biopsy:
  • Usually a biopsy is not required for moles that do not have worrisome features such as rapidly-growing mole, irregular borders, irregular pigmentation in mole color, itching that is getting worse, or bleeding and ulceration. If these indications are absent then a skin biopsy is not generally necessary. Due to the presence of these ‘worrisome’ signs, the mole is also referred to as an “ugly duckling mole”
  • A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis
  • For initial diagnosis, usually a punch biopsy of skin is preferred over a shave biopsy

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Dysplastic Mole?

The complications that may arise from a Dysplastic Mole may include:

• Transformation of the nevus/mole into a melanoma
• In some individuals, it may give rise to cosmetic concerns
• Scratching or itching of the moles may lead to bleeding and ulceration. This can cause secondary bacterial or fungal infections to develop

How is Dysplastic Mole Treated?

The treatment measures for Dysplastic Mole may include:

• Surgical excision and removal of the mole: A complete excision can result in a cure
• In cases where a mole is present as a flat pigmented patch, a shave biopsy of skin may be performed (known as saucerization excision or tangential excision); otherwise in majority of cases, a punch biopsy is preferred
• Proper follow-up care with regular screening and check-ups are important

How can Dysplastic Mole be Prevented?

Current medical research has not established a method of preventing a Dysplastic Nevus or Dysplastic Mole. However, the following measures can help these moles from turning into a melanoma or can help with early detection of malignant transformation:

• Minimize direct exposure to the sun’s ultraviolet (UV) rays
• Avoid tanning beds and sun lamps
• Perform self-examination of your skin, from head to toe, once a month (especially, if you are at risk)
• Get a professional skin exam from a healthcare provider once a year
• Also, undergo skin examinations regularly even after treatment, at least once a year (throughout one’s life)

What is the Prognosis of Dysplastic Mole? (Outcomes/Resolutions)

• The prognosis of Dysplastic Mole is excellent on its complete excision and removal
• However, if the mole turns into a melanoma, then the prognosis depends upon the stage of the melanoma

Additional and Relevant Useful Information for Dysplastic Mole:

• Avoid picking or scratching the moles
• It is important to note that a common mole does not become a melanoma with scratching, itching, or trauma. However, these should be avoided since bleeding and ulceration of skin may cause superimposed infections, as well as complicate the diagnosis in the future
• Common moles or acquired melanocytic nevi are of 3 types and these include:
  • Junctional common moles
  • Compound common moles
  • Intradermal common moles