White dysplastic melanocytic naevi

We describe three cases of a new variant of dysplastic melanocytic naevi (DMN), which is characterised by complete lack of pigmentation. Clinically, white DMN were non-pigmented white to pale-red macules with accentuated skin markings, and had a silvery, shiny appearance under tangential light. Histology showed characteristic features of DMN—ie, non-typical melanocytes arranged as solitary units and nests at the dermoepidermal junction and in the papillary dermis, and mild stromal changes. Association with malignant melanoma in all three patients emphasises the importance of this morphological type of DMN as a possible precursor to, or marker of, malignant melanoma.