The Evaluation of Clinical and Dermatoscopic Features of Scalp Nevi in Adults

Introduction: The dermatoscopic appearance of scalp tumors, especially melanocytic scalp lesions, differs from that on other body areas. Few studies have revealed the dermatoscopic characteristics of scalp nevi. Objectives: This study aimed to establish the clinical and dermatoscopic features of scalp nevi in adults and to compare dermatoscopic patterns according to the demographic and clinical features. Methods: This prospective study included 129 adult patients with 253 nevi. Demographic data of patients, clinical characteristics, and dermatoscopic features were recorded and compared. Results: The study enrolled 86 females (67%) and 43 males (33%) with a median age of 33.6 ± 11.3 years. The eclipse/reverse eclipse patterns were observed more frequently, while the papillomatous pattern was notably less common among younger patients than in older patients (P<0.001). The mean diameter of nevi was smaller in reticular pattern and larger in eclipse/reverse eclipse patterns (P<0.001). Vascular structures were present in 35.2% (N=89) of the nevi. While vessels were not observed in reticular pattern, vessels were present in 70% of the papillomatous pattern (P<0.001). Perifollicular hypopigmentation was observed in 53.8% (N=136) of the scalp nevi, and it was seen in almost all eclipse/reverse eclipse and reticular patterns (P<0.001). Conclusions: Dermatoscopic evaluation of scalp nevi provides more detailed information, helps to make a correct diagnosis, and facilitates patient management compared to clinical examination alone. Increasing awareness of the clinical characteristics and dermatoscopic features of scalp nevi can potentially decrease unnecessary surgical excisions.