Intradermal nevi with atypical nuclei in the elderly: The senescent nevus

Background Benign melanocytic nevi removed from elderly patients may demonstrate focal areas with nuclear atypia. Objective We sought to determine the prevalence of these nevi and their clinical and histologic features. Methods Intradermal nevi from patients older than 60 years were evaluated for areas of focal nuclear atypia and analyzed for 9 histologic characteristics. The patients' sex, biopsy sites, and clinical diagnoses were also tabulated. A statistical analysis of the 2 groups was undertaken. Results In all, 197 specimens from 157 patients were found. Twenty exhibited nuclear atypia (senescent nevi) and 177 did not (benign nevi). Significant differences were found for suggested clinical diagnosis, epithelioid-appearing melanocytes, the number of mast cells, evidence of solar elastosis, the number of intranuclear pseudoinclusions, and the presence of abnormally staining connective tissue. Limitations This is a single-site, retrospective analysis involving a modest number of specimens. In addition, only a single age group was evaluated and only intradermal nevi were examined. Conclusions The presence of focal nuclear atypia in benign melanocytic nevi in the elderly is not a rare finding. As these features are likely a result of the age of the lesion and possibly of long-standing ultraviolet light exposure, the term "senescent" nevus is suggested.