Alan S Boyd1, Sheau-Chiann Chen2, Yu Shyr2. 1. Department of Medicine, Division of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: alan.boyd@Vanderbilt.edu. 2. Center for Quantitative Studies, Vanderbilt University Medical Center, Nashville, Tennessee.
Abstract
BACKGROUND: Benign melanocytic nevi removed from elderly patients may demonstrate focal areas with nuclear atypia. OBJECTIVE: We sought to determine the prevalence of these nevi and their clinical and histologic features. METHODS: Intradermal nevi from patients older than 60 years were evaluated for areas of focal nuclear atypia and analyzed for 9 histologic characteristics. The patients' sex, biopsy sites, and clinical diagnoses were also tabulated. A statistical analysis of the 2 groups was undertaken. RESULTS: In all, 197 specimens from 157 patients were found. Twenty exhibited nuclear atypia (senescent nevi) and 177 did not (benign nevi). Significant differences were found for suggested clinical diagnosis, epithelioid-appearing melanocytes, the number of mast cells, evidence of solar elastosis, the number of intranuclear pseudoinclusions, and the presence of abnormally staining connective tissue. LIMITATIONS: This is a single-site, retrospective analysis involving a modest number of specimens. In addition, only a single age group was evaluated and only intradermal nevi were examined. CONCLUSIONS: The presence of focal nuclear atypia in benign melanocytic nevi in the elderly is not a rare finding. As these features are likely a result of the age of the lesion and possibly of long-standing ultraviolet light exposure, the term "senescent" nevus is suggested.
BACKGROUND: Benign melanocytic nevi removed from elderly patients may demonstrate focal areas with nuclear atypia. OBJECTIVE: We sought to determine the prevalence of these nevi and their clinical and histologic features. METHODS: Intradermal nevi from patients older than 60 years were evaluated for areas of focal nuclear atypia and analyzed for 9 histologic characteristics. The patients' sex, biopsy sites, and clinical diagnoses were also tabulated. A statistical analysis of the 2 groups was undertaken. RESULTS: In all, 197 specimens from 157 patients were found. Twenty exhibited nuclear atypia (senescent nevi) and 177 did not (benign nevi). Significant differences were found for suggested clinical diagnosis, epithelioid-appearing melanocytes, the number of mast cells, evidence of solar elastosis, the number of intranuclear pseudoinclusions, and the presence of abnormally staining connective tissue. LIMITATIONS: This is a single-site, retrospective analysis involving a modest number of specimens. In addition, only a single age group was evaluated and only intradermal nevi were examined. CONCLUSIONS: The presence of focal nuclear atypia in benign melanocytic nevi in the elderly is not a rare finding. As these features are likely a result of the age of the lesion and possibly of long-standing ultraviolet light exposure, the term "senescent" nevus is suggested.