ABSTRACT
Clark Nevus-Like Melanomas (Fig. 8f.1) In our experience, over 50% of all melanomas removed were initially clinically diagnosed as probable Clark nevi. Most of these melanomas were diagnosed in patients with multiple atypical nevi or Clark nevi. In patients with numerous Clark nevi it is important to maximize both sensitivity and specifi city, which translates into detecting early melanomas without the added morbidity associated with the removal of many benign nevi including Clark’s nevi/dysplastic nevi. This can be achieved by digital monitoring and this explains why many of the melanomas in these patients were detected and biopsied because of changes noted on sequential digital followup (both short-term and long-term monitoring). Other dermoscopic features that led to the removal of these melanomas included the presence of regression structures and/or the presence of peripheral hyperpigmentation. It was also observed that some of these melanomas presented with uniform or central hyperpigmentation, multifocal hyper-and/or hypopigmentation, or central hypopigmentation.
