The atypical histologic features considered to be specific to dysplastic (a
typical) nevi have been reported to occur in nevi that are common nevi by a
ll other clinical and histologic features. The distribution and mutual rela
tions among such features in nevi need to be further studied. Six histologi
c features (dimension > 5 mm, lentiginous proliferation, disordered nested
pattern, melanocytic dyskaryosis, dermal lymphocytic infiltrate, suprabasal
melanocytes) were analyzed in 253 melanocytic nevi with different clinical
appearances. Atypical histologic features, found in 72% of nevi, occurred
singly or formed numerous and highly variable combinations. Nevi formed a c
omplex histologic spectrum comprising lesions showing a progressively incre
asing incidence of atypical features rather than two classes (common and dy
splastic nevi). To divide the investigated lesions in objectively defined g
roups, we used a scoring system. In each nevus, a numeric value of 1 was as
signed when each of the studied parameters was present and a value of 0 was
assigned when each of these parameters was absent; on the basis of the fin
al scores, nevi were divided in six different classes (classes 0-5). Diagno
stic categories such as dysplastic nevi and common nevi seem to be inapprop
riate. as they do not reflect the real histologic complexity of such lesion
s.