The patient has dysplastic nevi, and he should be taught how to perform monthly self-examinations and should be referred to a dermatologist for close clinical monitoring. Dysplastic nevi are benign melanocytic lesions most commonly found on the trunk and extremities. In contrast to common nevi, they have one or more atypical clinical features that may make them difficult to distinguish from malignant melanoma. Histologically, they possess varying degrees of cytologic atypia and architectural disorder. Although benign, they often serve as a marker for persons who have a higher than average risk of developing melanoma. Any lesions suspicious for melanoma should be removed and sent for histologic evaluation.

Partial biopsy of multiple pigmented lesions is not recommended since it leaves room for sampling error and the possibility of nevus recurrence. If a given pigmented lesion is worrisome for melanoma, it should be removed in its entirety whenever possible and sent for pathologic analysis.

Patients with dysplastic nevus syndrome often have large numbers of nevi. Removal of either the largest lesions or nevi en masse has not been shown to reduce the risk of developing melanoma, is often not practical, and is not cost effective; therefore, neither procedure is recommended. In patients with numerous dysplastic nevi who develop melanoma, approximately two thirds of the time the melanoma will arise on normal appearing skin rather than within a preexisting nevus. Thus, even if all of a patient's nevi were removed, the overall risk would only be partially reduced.