Retrospective investigation of the dermoscopic and histological properties of flexural nevi̇

It is asserted that benign nevi of anatomical locations so called special sites have more atypical characteristics compared to nevi of other sites.Called as special site nevi, these nevi are seen in acral sites, scalp, genital and flexural regions. In this study, nevi excised from flexural regions are assessed in terms of dermoscopy and histopathology. In this study, dermoscopic and histopathologic charecteristics of 75 melanocytic nevi excised from axillary , breast, periumbilical, inguinal, mons pubis, scrotum, intergluteal areas and labium majus were evaluated. In dermoscopic evaluations, clinical photographs of lesions were lined so that the observer did not have the localization knowledge of nevi. All pathology specimens were evaluated by pathologists two times firstly without the localization information and then with localization information. Average size of nevi was determined as 0,86 cm. %80 of nevi were in in brown and its tones.The most frequent pattern was reticulo-globular pattern ( %25,3) . All six nevi having broken-up network were localized in breasts. The most frequent dermoscopic charecteristics seen in nevi were irregular dots (%60), asymmetry (%56), erythema (%50,6), irregular globules ( %48) . In histopathologic examination , in %50 of nevi ,dermal and nest patterns were observed. The most frequent histopathologic charecteristics were acanthosis(%61,3 ), host reaction (%57,3) , increased vascularization (%53,3), cytologic atypia( %41,3). Nevi identifications based on two pathological evaluations were consistent with each other and with dermoscopic evaluation. In other words, when dermoscopic structures consistent with dyplastic nevi criteria and early melanoma criteria were found , histopathological examination was also consistent with dysplastic nevus. Lesions with melanoma diagnosis were excluded from the study. On the other hand, classical dermoscopic features seen in other sites congenital nevi were also observed in special site congenital site nevi. We think, evaluation of flexural sites localized nevi should be based on both of dermoscopic and histopathologic findings. There is no evidence in literature which can state that a lesion atypical in terms of dermoscopy and histopathology can be evaluated as not a truely atypical lesion just because of its flexural anatomic localization. In our study, we didn't detect any feature which may cause dermoscopic tand histopathologic diagnostic inconsistency