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Pathways to Involution of Nevi Insights From Dermoscopic Follow-up

Vitaly Terushkin, BS; Alon Scope, MD; Allan C. Halpern, MD; Ashfaq A. Marghoob, MD
Arch Dermatol. 2010;146(4):459-460. doi:10.1001/archdermatol.2010.20.
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The life of a melanocytic nevus can be conceptually divided into 3 stages: inception to growth, senescence, and involution. Dermoscopy has provided insights into understanding the first 2 stages of nevogenesis.13 Herein, we show longitudinal changes in dermoscopic features of nevi that highlight distinct pathways to nevus involution.

The first nevus demonstrates disappearance via a halo phenomenon.4 During dermoscopic follow-up (Figure 1 [A, at baseline in a 33-year-old patient; B, after 12 months; and C, after 2½ additional years]), the pigmented central portion, which has a globular-homogeneous dermoscopic pattern, became progressively smaller and was replaced by the centripetally growing depigmented halo. The remaining hypopigmented macule usually repigments and becomes inconspicuous. An immune-mediated process primarily involving T-cell lymphocytes has been implicated in this phenomenon.5

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