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Combined Naevus — SCE Dermatology MCQ

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ModerateSkin CancerCombined NaevusSCE Dermatology

A 50-year-old man has a melanocytic naevus that shows dermoscopic features of a combined naevus — part showing regular pigment network (dermal/junctional naevus component) and part showing homogeneous steel-blue pigmentation (blue naevus component). What is a combined naevus?

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Correct answer: D — A single naevus containing two distinct melanocytic cell populations with different dermoscopic patterns

A combined naevus is a single melanocytic lesion containing two or more distinct populations of melanocytic cells — most commonly a common melanocytic naevus (junctional/dermal) combined with a blue naevus. Dermoscopy shows two distinct patterns within one lesion: regular pigment network (superficial naevus component) adjacent to homogeneous blue pigmentation (deep dermal melanocyte component). Combined naevi are benign but can be confused with melanoma due to their multicomponent appearance. The key distinguishing feature is that each component is individually recognisable as benign. If dermoscopy shows atypical features within either component, excision biopsy is warranted.

Reference: BAD 2016 Dermoscopy Guidelines