Clinico-dermoscopic and histopathological correlations of benign melanocytic nevi of the skin as a basis for the choice of treatment and recurrence prevention (literature review)

Benign melanocytic nevi are among the most common skin lesions and frequently require diagnostic and therapeutic interventions in dermatological practice. Despite the widespread implementation of dermoscopy, difficulties in the differential diagnosis of various clinico-morphological types of nevi and in the selection of optimal treatment strategies persist. Incomplete removal of pigmented lesions is associated with the development of the recurrent nevus phenomenon, scar formation, and diagnostically challenging pigmentation changes, highlighting the need for a comprehensive synthesis of current evidence on clinico-dermoscopic and histopathological correlations. The aim of the study was to analyze and substantiate current scientific data on the clinical, dermatoscopic, and pathomorphological features of various clinical and morphological forms of benign melanocytic skin nevi to justify the individualized choice of treatment method aimed at reducing the frequency of inverse nevus development, minimizing postoperative complications, and achieving optimal cosmetic results. The review was conducted as a narrative analytical with elements of a one structured search in accordance with PRISMA recommendations. Bibliographic, analytical, synthetic, and comparative methods, as well as data systematization and generalization techniques, were applied. The literature search was performed in the PubMed/MEDLINE and PubMed Central databases, covering the period from 2009 to 2025. A total of 312 publications were identified during the initial search. After duplicates removal, 268 records were screened, and 97 articles were selected based on title and abstract evaluation. Following full-text assessment, 54 publications were included in the final qualitative analysis. Inclusion criteria comprised review articles, clinical and clinico-morphological studies, as well as international consensus recommendations that reported data on dermoscopic and histopathological characteristics of benign melanocytic nevi and treatment methods. Exclusion criteria included isolated case reports without analytical synthesis, publications focused exclusively on melanoma, and studies without full-text availability. The keywords used were “melanocytic nevi,” “dermoscopy,” “histopathological correlations,” “recurrent nevus,” and “treat­ment methods.” The analysis demonstrated that dermoscopic patterns of benign melanocytic nevi reflect their un­derlying histopathological architecture and vary depending on patient age, lesion duration, and anatomical localization. A strong association was identified between specific dermoscopic features and the depth of melanocytic components, which is of critical importance for treatment selection. Partial removal techniques, including shave excision and ablative procedures, were associated with a higher risk of repigmentation and recurrent nevus development, whereas complete surgical excision provided the highest diagnostic reliability due to the possibility of primary histopathological verification, but it may be accompanied by a more pronounced scarring. The findings support the rationale for an individualized management strategy for benign melanocytic nevi based on the integration of clinical, dermoscopic, and histopathological data, aiming to reduce recurrence rates, minimize diagnostic uncertainty, and improve cosmetic outcomes.