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Intradermal nevi in elderly patients often have focal areas of atypical nuclei

Researchers found focal areas of atypical nuclei in intradermal nevi of elderly patients, and suggested these nevi be categorized as senescent to describe the age and ultraviolet light exposure of these areas.

“In sum, there exists within the cohort of benign intradermal nevi a subset exhibiting focal areas of nuclear atypia. These senescent nevi demonstrate statistically increased amounts of solar elastosis, abnormally staining connective tissue, and nuclear pseudoinclusions,” Alan S. Boyd, MD, and colleagues wrote. “It is important that pathologists recognize senescent nevi to prevent their misinterpretation as anything other than benign.”

Boyd and colleagues evaluated 197 nevi from 156 patients and divided the nevi into two groups: one with focal atypia and one without. Patients were older than 60 years, and the researchers recorded the biopsy sites, gender and clinical diagnoses of each patient. When considering focal atypia, the researchers examined whether nevi had nuclear enlargement, thickened nuclear membranes, hyperchromasia, pleomorphism, multiple or enlarged nucleoli, binucleation and a change in nucleolar color.

The researchers found 20 senescent nevi (7%). Compared with benign nevi, the senescent nevi had nuclear atypia, including significant differences in the number of mast cells, epithelioid-appearing melanocytes, number of intranuclear pseudoinclusons, abnormally staining connective tissue, evidence of solar elastosis and suggested clinical diagnoses compared to benign nevi, according to the researchers.

Disclosure: The researchers report no relevant financial disclosures.