[3 min read] Dysplastic naevi genetic makeup

dysplastic naevi

This month, I share a useful review article on the often vexed topic of dysplastic naevi. The article summarises new understandings about the genetic makeup of benign and dysplastic naevi, as well as melanoma.

The summary by Ardakani is well worth reading for everyone, and if you want to explore issues around dysplastic naevi more, read the whole article.

In short, what Ardakani shows is that there does seem to be a subset of dysplastic naevi that has a distinct genetic makeup that is different from other dysplastic naevi. However, it is not clear what the genetic changes mean in a biological or clinical way.

So, while our understanding of the detailed biology of naevi continues to grow, we (as GPs) can continue to manage dysplastic naevi as we do now.

That is, any suspicious pigmented skin lesion should be biopsied by excision biopsy (2mm margins). If the pathology report is of mild or moderate dysplasia, no further treatment is needed. If the report is of severe dysplasia, the lesion should be treated as melanoma in situ, and a re-excision with 5mm margins done.

Professor David Wilkinson


Read more from Professor David Wilkinson on recent research:


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Case discussion: How would you treat this patient? [8 April]

Case discussion

This week we have an interesting case from Dr Risto Cvetkovic. Have a look at the clinical and dermoscopy images.

What is your differential and what would you do next? What approach do you take here? Biopsy? If so, how?

Continue reading “Case discussion: How would you treat this patient? [8 April]”

[9 min watch] Skin Cancer Update with Prof Giuseppe Argenziano [April 2019]

Skin cancer update

In this month’s skin cancer update video, Professor Giuseppe Argenziano continues his discussion from last month about atypical melanocytic lesions: lesions that are histopathologically in between a melanoma and a naevus, with subtle melanoma criteria that are not enough for the pathologist to diagnose the lesion as a melanoma. Continue reading “[9 min watch] Skin Cancer Update with Prof Giuseppe Argenziano [April 2019]”

Case discussion: How would you treat this patient? [1 April]

Case discussion

This week we have an engaging case from Dr David Stewart. There is no history, but that is often our reality.

What do you make of the clinical and dermoscopy pictures here? What approach do you take here? Biopsy? If so, how?

Continue reading “Case discussion: How would you treat this patient? [1 April]”

[3 min read] What to do when a partial biopsy of a suspected melanoma is performed

partial biopsy

This month, we consider what to do when a partial biopsy of a suspected melanoma is performed.

The general advice is that if a punch or shave (partial) biopsy has been done, then an excision biopsy should be done before a formal wide-local excision. This is so that complete staging (of Breslow thickness) can be assured before the excision is done. Continue reading “[3 min read] What to do when a partial biopsy of a suspected melanoma is performed”

Case discussion: How would you treat this patient? [25 March]

Case discussion

This week we have an interesting case. No clinical image or history.

What do you make of the dermoscopic image below? How would you biopsy?

Continue reading “Case discussion: How would you treat this patient? [25 March]”

[7 min watch] Skin Cancer Update with Prof Giuseppe Argenziano [March 2019]

Skin cancer update

In this month’s skin cancer update video, Professor Giuseppe Argenziano talks about atypical melanocytic lesions: lesions that are histopathologically in between a melanoma and a naevus, with subtle melanoma criteria that are not enough for the pathologist to diagnose the lesion as a melanoma. Continue reading “[7 min watch] Skin Cancer Update with Prof Giuseppe Argenziano [March 2019]”

[3 min read] Artificial Intelligence in clinical practice

artificial intelligence

This month, we touch on Artificial Intelligence (AI) again, because this is such a fast-moving and fascinating field. Two very well written and short pieces are worth looking at and considering. Continue reading “[3 min read] Artificial Intelligence in clinical practice”

[7 min watch] Skin Cancer Update with Prof Giuseppe Argenziano [January 2019]

Skin cancer update

In this skin cancer update, Professor Giuseppe Argenziano discusses treatments for difficult advanced melanoma cases. Looking at real patient examples, Giuseppe describes the options for treatment, including the factors physicians should consider when choosing therapies for their patients. Continue reading “[7 min watch] Skin Cancer Update with Prof Giuseppe Argenziano [January 2019]”

Skin Cancer Update with Prof Giuseppe Argenziano [December 2018]

skin cancer update

[6 min watch] In this skin cancer update, Professor Giuseppe Argenziano discusses the best practice for patient follow-up, especially for patients with multiple moles.  Continue reading “Skin Cancer Update with Prof Giuseppe Argenziano [December 2018]”