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The American Journal of Dermatopathology Sep 2022In dermal melanocytoses such as blue nevus or nevus of Ota, an ultrastructural study has demonstrated an intimate relationship between the dendritic melanocytes and the...
In dermal melanocytoses such as blue nevus or nevus of Ota, an ultrastructural study has demonstrated an intimate relationship between the dendritic melanocytes and the dermal elastic fibers with elongated cytoplasmic processes of the melanocytes aligning lengthwise along the axis of the elastic fibers in longitudinal sections and encircling the elastic fibers in cross-sections. Such a close arrangement has not been reported in common melanocytic nevi. The current case described a similar arrangement between the melanocytes and the dermal elastic fibers in a usual intradermal melanocytic nevus. Of note, as the melanocytes matured with descent, the deep melanocytes were arranged in single cells embracing the elastic fibers, imparting a signet-ring cell/phagocytosis appearance. A Verhoeff-van Gieson stain showed hypertrophy of the melanocyte-associated elastic fibers compared with the elastic fibers in the dermal background, suggesting a paracrine or juxtracrine interaction between the melanocytes and the dermal cellular components. Because of the distinctive affinity of the melanocytes to the dermal elastic fibers in this melanocytic lesion, the term melanocytic nevus with elastophilic features is suggested for this peculiar melanocytic variant.
Topics: Humans; Melanocytes; Nevus; Nevus, Epithelioid and Spindle Cell; Nevus, Pigmented; Skin Neoplasms
PubMed: 35503877
DOI: 10.1097/DAD.0000000000002207 -
Seminars in Diagnostic Pathology Aug 1998Ancient melanocytic nevus is an example of a simulator of malignant melanoma, designated ancient because it shares numerous features with ancient schwannoma. Knowledge... (Review)
Review
Ancient melanocytic nevus is an example of a simulator of malignant melanoma, designated ancient because it shares numerous features with ancient schwannoma. Knowledge of the histopathologic characteristics of this benign melanocytic neoplasm should enable pathologists to avoid overdiagnosis of it as melanoma arising in the intradermal portion of a nevus. Ancient nevi are found most commonly on the face of older persons. The neoplasm is usually a dome-shaped, skin-colored or reddish brown papule, usually with features of a Miescher's nevus. Histopathologically, ancient nevi are exoendophytic, mostly intradermal proliferations of two populations of melanocytes: one with large pleomorphic nuclei and the other with small monomorphous ones. The large melanocytes may resemble those of the epithelioid type of Spitz's nevus. A few mitotic figures may be present in a particular section. The epidermis usually is uninvolved, but sometimes there may be a junctional component. Other important findings are degenerative changes that include thrombi, zones of hemorrhage, pseudoangiomatous changes, thick rims of sclerosis around dilated venules, fibrosis, and mucin. Ancient nevi frequently are misdiagnosed as melanoma arising in an intradermal nevus.
Topics: Aged; Aged, 80 and over; Diagnosis, Differential; Diagnostic Errors; Face; Female; Follow-Up Studies; Humans; Male; Melanocytes; Melanoma; Middle Aged; Neoplasms, Second Primary; Nevus, Pigmented; Skin Neoplasms
PubMed: 9711671
DOI: No ID Found -
Annals of Diagnostic Pathology Oct 2022The primary differential diagnosis of melanoma is dysplastic nevus. Until now, the final diagnosis is based on histological findings. With modern techniques,... (Review)
Review
The primary differential diagnosis of melanoma is dysplastic nevus. Until now, the final diagnosis is based on histological findings. With modern techniques, pathologists receive very early melanocytic lesions, which do not fit all malignant criteria. In those cases, even the concurrence between specialists and intraobserver agreement is not good. A molecular test could be developed to improve the accuracy of melanocytic lesions diagnosis and help in challenging lesions. The objective of this study is to provide a literary review looking for molecular markers that characterize dysplastic nevi and could help surgical pathologists differentiate them from melanoma. Articles from PubMed presenting case series of dysplastic nevi and melanoma genomic analyses were considered. The search was conducted in PubMed looking for papers written in English, published in the ten years preceding April 2020. This review confirmed the absence of a pathognomonic molecular marker of dysplastic nevi. This is a heterogeneous group of lesions with an uncertain risk to become a melanoma. The molecular heterogeneity of dysplastic nevi, the variation of histological diagnostic criteria among services, and the diverse molecular techniques applied are challenging features that might hamper definitive diagnoses. However, currently, there appears to be limited value for molecular testing in the diagnosis of dysplastic nevi.
Topics: Diagnosis, Differential; Dysplastic Nevus Syndrome; Humans; Melanocytes; Melanoma; Nevus; Nevus, Pigmented; Skin Neoplasms
PubMed: 35839551
DOI: 10.1016/j.anndiagpath.2022.152006 -
Duodecim; Laaketieteellinen... 2010The dysplastic melanocytic nevus remains an issue of controversy despite extensive investigations. On clinical grounds the term atypical melanocytic nevus should be... (Review)
Review
The dysplastic melanocytic nevus remains an issue of controversy despite extensive investigations. On clinical grounds the term atypical melanocytic nevus should be used, while dysplastic melanocytic nevus describes histological characteristics. The association with melanoma is complex. With the clinical picture, dermatoscopy and molecular biological or genetic examinations one can often not distinguish a histological dysplastic nevus from a melanoma. In patients with large amounts of melanocytic nevi it is important to assess the total melanoma risk, the need for patient surveillance and motivate the patient for self-examination. In high-risk patients the amount of benign melanocytic nevi is increased and many clinically atypical and microscopically dysplastic nevi can be found. The relatives of these patients should also be examined. Because of the rising incidence of melanoma and the lack of therapeutic options in disseminated disease, the surveillance of high risk patients, the early detection of melanoma and excision play a key role in patient management.
Topics: Dermoscopy; Diagnosis, Differential; Dysplastic Nevus Syndrome; Humans; Melanoma; Nevus, Pigmented; Self-Examination; Skin Neoplasms
PubMed: 21171474
DOI: No ID Found -
Anais Brasileiros de Dermatologia 2013Giant congenital melanocytic nevus is usually defined as a melanocytic lesion present at birth that will reach a diameter ≥ 20 cm in adulthood. Its incidence is... (Review)
Review
Giant congenital melanocytic nevus is usually defined as a melanocytic lesion present at birth that will reach a diameter ≥ 20 cm in adulthood. Its incidence is estimated in <1:20,000 newborns. Despite its rarity, this lesion is important because it may associate with severe complications such as malignant melanoma, affect the central nervous system (neurocutaneous melanosis), and have major psychosocial impact on the patient and his family due to its unsightly appearance. Giant congenital melanocytic nevus generally presents as a brown lesion, with flat or mammilated surface, well-demarcated borders and hypertrichosis. Congenital melanocytic nevus is primarily a clinical diagnosis. However, congenital nevi are histologically distinguished from acquired nevi mainly by their larger size, the spread of the nevus cells to the deep layers of the skin and by their more varied architecture and morphology. Although giant congenital melanocytic nevus is recognized as a risk factor for the development of melanoma, the precise magnitude of this risk is still controversial. The estimated lifetime risk of developing melanoma varies from 5 to 10%. On account of these uncertainties and the size of the lesions, the management of giant congenital melanocytic nevus needs individualization. Treatment may include surgical and non-surgical procedures, psychological intervention and/or clinical follow-up, with special attention to changes in color, texture or on the surface of the lesion. The only absolute indication for surgery in giant congenital melanocytic nevus is the development of a malignant neoplasm on the lesion.
Topics: Age Factors; Disease Progression; Female; Humans; Male; Melanoma; Nevus, Pigmented; Risk Factors; Skin Neoplasms
PubMed: 24474093
DOI: 10.1590/abd1806-4841.20132233 -
The Journal of Investigative Dermatology Sep 2023
Topics: Humans; Epigenome; Nevus, Pigmented; Skin Neoplasms; Nevus
PubMed: 37436336
DOI: 10.1016/j.jid.2023.03.1670 -
Romanian Journal of Morphology and... 2014Melanocytic nevi are frequently accompanied by inflammatory cells of different types, in varied amounts and distributed in different patterns. In the current report, we... (Review)
Review
Melanocytic nevi are frequently accompanied by inflammatory cells of different types, in varied amounts and distributed in different patterns. In the current report, we review the knowledge on inflammation seen in different types of melanocytic nevi. As an additional contribution, we studied the lymphocytic inflammatory component of Duperrat nevus, as well as the cytotoxic component of Sutton nevus, two contributions that we have not found in the literature. We conclude that: (a) Duperrat nevus has a mixed inflammatory reaction that includes histiocytes, foreign-body multinucleated giant cells, polymorphonuclears, lymphocytes (predominantly CD4+) and plasma cells (commonly abundant); (b) common melanocytic nevi with reactive inflammatory infiltrate usually show a CD4+ predominant population; (c) Meyerson nevus commonly shows an inflammatory infiltrate mainly made up of CD4+ T-cells; (d) Sutton nevus with halo phenomenon is accompanied by a dense inflammatory infiltrate with lymphocytes in a CD4:CD8 ratio varying from 1:1 to 1:3 and in which most of the CD8+ T-cells do not express cytotoxic markers; (e) Wiesner nevus commonly shows a spare lymphocytic infiltrate but the nature of the infiltrate has not yet been investigated.
Topics: CD8-Positive T-Lymphocytes; Humans; Inflammation; Nevus, Pigmented; Plasma Cells; Remission Induction; Skin Neoplasms
PubMed: 25611257
DOI: No ID Found -
The Pan African Medical Journal 2022
Topics: Humans; Nevus, Pigmented; Melanoma; Skin Neoplasms
PubMed: 36303818
DOI: 10.11604/pamj.2022.42.250.35727 -
The American Journal of Dermatopathology Dec 2019
Topics: Humans; Melanoma; Nevus, Blue; Nevus, Pigmented; Skin Neoplasms
PubMed: 30839346
DOI: 10.1097/DAD.0000000000001381 -
Indian Journal of Dermatology,... 2019
Topics: Adult; Diagnosis, Differential; Female; Humans; Nevus, Pigmented; Skin Neoplasms; Skin Transplantation
PubMed: 30058569
DOI: 10.4103/ijdvl.IJDVL_657_17