Melanocytic naevi of special sites

There is a recently recognized and relatively common group of melanocytic naevi that share histopathologic features in common with dysplastic naevi and malignant melanoma. These naevi have been termed “naevi of special sites” or “naevi with site-related atypia” as distinctive features have been correlated with specific anatomic sites. The list of sites attributed with bearing such naevi is expanding and includes genitals, acral locations, flexural areas, breast, scalp, auricular regions, and conjunctiva. Despite the atypical histopathologic features, the vast majority of these lesions are benign and do not appear to have an increased risk for progression to malignancy. As authentic dysplastic naevi and melanoma may also occur at these sites, it is important for practicing diagnostic pathologists to recognize the unique features of “naevi of special sites” and avoid overdiagnosis. This group of melanocytic naevi, with emphasis on histopathologic features and distinction from dysplastic naevi and melanoma, is briefly reviewed.