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Atypical melanocytic hyperplasia

Anamaria Balić, Borna Pavičić, Branka Marinović, Ružica Jurakić Tončić
Dear Editor, There are few literature data about nevi in patients with a history of toxic epidermal necrolysis (TEN) and little recommendations for follow-up and risks of melanoma (MM). Eruptive melanocytic nevi (EMN) is a rare phenomenon that has been associated with bullous disorders, immunosuppression, and immunodeficiency, but in some cases can occur without precipitating factors (1). The etiology is largely unknown, but there is evidence that immunosuppression might play a crucial role in nevogenesis, probably due to the inability of the immune system to inhibit melanocytic (MC) proliferation (2,3)...
June 2018: Acta Dermatovenerologica Croatica: ADC
C Theillac, E Cinotti, J Malvehy, S Ronger Savle, B Balme, P Robinson, J L Perrot, C Douchet, A C Biron Schneider, L Alos, A Garcia, A Barreiro, B Labeille, G Duru, S Dalle, L Thomas, S Debarbieux
BACKGROUND: Vulvar melanosis can occasionally be clinically challenging by mimicking an early melanoma. OBJECTIVE: To report our experience of initial evaluation and follow-up in this peculiar subset of vulvar melanosis using reflectance confocal microscopy (RCM). METHODS: We retrospectively evaluated 18 consecutive cases referred for atypical vulvar pigmentation or for which melanoma was considered and that underwent both RCM examination and histopathological assessment...
June 19, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Sonal Muzumdar, Melissa Argraves, Arni Kristjansson, Katalin Ferenczi, Soheil S Dadras
Histologic differentiation of melanoma in situ (MIS) from solar keratosis on chronically sun-damaged skin is challenging. The first-line immunostain is usually MART-1/Melan-A, which can exaggerate the epidermal melanocytes, causing a diagnostic pitfall for MIS. By comparing MART-1 and SOX10 immunostaining, we scored the percentage of epidermal melanocytes per 2-mm diameter fields in pigmented actinic keratosis (n = 16), lichenoid keratosis (n = 7), junctional melanocytic nevus (n = 6), keratosis with atypical melanocytic proliferation (n = 17) and MIS (n = 10)...
April 2018: Journal of Cutaneous Pathology
Danielle Carvalho Quintella, Gabriella Campos-do-Carmo, Leonardo Pereira Quintella, Tullia Cuzzi
The concern about malignant skin neoplasms leads to the excision of smaller lesions. This study on small melanocytic lesions aims to evaluate the range of possible histopathological diagnoses, describe histopathological aspects, and assess the usefulness of serial histological sections. We performed a cross-sectional descriptive histopathological study examining 76 pigmented skin lesions up to 6 mm in diameter. Histopathological diagnoses included atypical melanocytic nevi (n=38), common melanocytic nevi (n=18), atypical lentiginous melanocytic hyperplasia with architectural features of atypical melanocytic nevi (n=7), lentigo simplex (n=2), and malignant melanoma (n=1)...
May 2017: Anais Brasileiros de Dermatologia
Isidro Machado, Beatriz Llombart, Julia Cruz, Víctor Traves, Celia Requena, Eduardo Nagore, Antonina Parafioriti, Carlos Monteagudo, Antonio Llombart-Bosch
Desmoplastic melanoma (DM) and cutaneous malignant peripheral nerve sheath tumors (MPNST) reveal histological and immunohistochemical similarities, including S100 positivity and negative staining for conventional melanocytic markers. We present 3 cases of cutaneous S100-positive spindle cell tumors in elderly patients, in which first findings led to initial misdiagnoses as cutaneous MPNST and benign peripheral sheath nerve tumor (neurofibroma). The identification of adjacent atypical melanocytic hyperplasia in the overlying skin along with tumor cell proliferation, also in the superficial dermis, the neurotropic component and the absence of any relationship between the tumor and a major nerve, pre-existing neural benign tumor or the existence of stigmata suggestive of neurofibromatosis raised consideration of a DM...
April 12, 2017: Journal of Cutaneous Pathology
William C Yao, Kevin S Emerick, Stefan Kraft, Eric H Holbrook
BACKGROUND: The progression from a benign pigmented lesion on the skin to cutaneous melanoma is better understood, and it could be presumed that a similar progression occurs with mucosal lesions. However, to our knowledge, there has never been documentation of melanosis transforming into melanoma over time. OBJECTIVE: To describe a transformation of a mucosal melanosis into melanoma. METHODS: A 53-year-old man with diffuse melanosis of the nasal cavity underwent surgical resection...
January 1, 2016: Allergy & Rhinology
J R Marsden, R Fox, N M Boota, M Cook, K Wheatley, L J Billingham, N M Steven
BACKGROUND: Topical imiquimod is sometimes used for lentigo maligna (LM) in situ melanoma instead of surgery, but frequency of cure is uncertain. Pathological complete regression (pCR) is a logical surrogate marker for cure after imiquimod, although residual LM and atypical melanocytic hyperplasia may not be reliably distinguished. A trial comparing imiquimod vs. surgery might be justified by a high imiquimod pCR rate. OBJECTIVES: Primary: to estimate the pCR rate for LM following imiquimod...
May 2017: British Journal of Dermatology
Phoebe Star, Pascale Guitera
Distinguishing lentigo maligna (LM) and lentigo maligna melanoma (LMM) from background pigmented non-melanoma lesions is challenging. The field of solar damage can obscure clinical assessment, and diagnostic ambiguities are created due to the overlap of the clinical features of LM with other benign lesions. Moreover, margin assessment on histology is limited by the resemblance between melanocytic hyperplasia of actinically damaged skin and scattered atypical melanocytes of LM/LMM. Dermoscopy has made a significant contribution but is often not sufficient for diagnosis and margin assessment...
October 2016: Dermatologic Clinics
Anthony P Fernandez, Steven D Billings, Wilma F Bergfeld, Jennifer S Ko, Melissa P Piliang
BACKGROUND: Pagetoid Spitz nevus is an uncommon Spitz nevus variant characterized by a predominantly intraepidermal proliferation of single epithelioid melanocytes. Recognition of this variant is important to avoid misdiagnosis as melanoma. METHODS: We reviewed and characterized 12 pagetoid Spitz nevi diagnosed at a tertiary care institution over the past 25 years. RESULTS: All patients were female and average age at biopsy was 34 years. Clinically, 83% (10 out of 12) were located on an extremity and all were ≤ 6 mm in diameter...
November 2016: Journal of Cutaneous Pathology
Mark R Wick
As cutaneous melanomas manifest a wide spectrum of clinical and pathologic presentations, several other lesions enter into their differential diagnosis. This article considers those entities, including melanocytic hyperplasia, cellular nodules in congenital nevi, atypical lentiginous melanocytic proliferations, "special site" nevi, epithelioid histiocytoma, neurothekeoma, cellular schwannoma, and proliferating scars.
July 2016: Seminars in Diagnostic Pathology
Maya Zayour, Rossitza Lazova
This article reviews congenital melanocytic nevi (CMN), which are present at birth or appear shortly thereafter, and their main histologic features. Several histologic variants and histopathologic criteria that differentiate CMN from other nevi, such as atypical or dysplastic nevi, and from nevoid malignant melanoma, are discussed. Histologic pitfalls in the correct identification of lentiginous melanocytic hyperplasia, pagetoid scatter, and proliferative nodules in the context of CMN are discussed. The risk for development of malignant melanoma in association with a congenital melanocytic nevus and variable causes for changing mole are discussed...
September 2009: Surgical Pathology Clinics
Frederick A Jakobiec
PURPOSE: To review the diagnostic categories of a group of conditions referred to as "primary acquired melanosis." DESIGN: Literature review on the subject and proposal of an alternative diagnostic schema with histopathologic and immunohistochemical illustrations. METHODS: Standard hematoxylin-eosin-stained sections and immunohistochemical stains for MART-1, HMB-45, microphthalmia-associated transcription factor (MiTF), and Ki-67 for calculating the proliferation index are illustrated...
February 2016: American Journal of Ophthalmology
Richard R Winkelmann, Jane Yoo, Natalie Tucker, Richard White, Darrell S Rigel
OBJECTIVE: To determine how a multispectral digital skin lesion analysis (MSDSLA) device data affects the biopsy performance of dermatologists and non-dermatologist practitioners following clinical and dermoscopic pigmented lesion evaluation. DESIGN: MSDSLA employs near infrared light to image and analyze pigmented skin lesions. MSDSLA generates a "classifier score" based on morphological disorganization. Using a logistical regression model, 1) a probability of being melanoma and, 2) a probability of being melanoma, atypical melanocytic hyperplasia, or a high grade dysplastic nevus is computed...
September 2015: Journal of Clinical and Aesthetic Dermatology
Chelsea Cooper, Nicoleta C Arva, Christina Lee, Oriol Yélamos, Roxana Obregon, Lauren M Sholl, Annette Wagner, Lisa Shen, Joan Guitart, Pedram Gerami
BACKGROUND: The current literature suggests that approximately 5% to 10% of melanonychia striata cases in adults are the result of subungual melanoma. OBJECTIVE: We sought to evaluate the clinical and histopathologic features and to determine the outcomes and causes of melanonychia striata in a cohort of children. METHODS: We assessed 30 childhood cases of melanonychia striata for features typically associated with melanoma such as Hutchinson sign, width of the pigmented band, evolution, color, and nail dystrophy...
May 2015: Journal of the American Academy of Dermatology
Mary Elizabeth Danga, Ron Yaar, Jag Bhawan
The presence of Melan-A positive dermal cells in excisions for melanoma in situ represents a frequent conundrum for pathologists. These cells may represent superficially invasive melanoma, benign, incidental, dermal nevi or non-specific staining of dermal melanophages. Occasionally, rare, Melan-A positive dermal cells are present which do not clearly correspond to the above three categories. Our objective was to further characterize these Melan-A positive dermal cells. To do this, immunoperoxidase staining for Melan-A and SOX-10 was performed on 188-cutaneous excisions, including examples of melanoma in situ, atypical junctional melanocytic hyperplasia and non-melanocytic tumors...
June 2015: Journal of Cutaneous Pathology
Richard R Winkelmann, Jane Yoo, Natalie Tucker, Richard White, Darrell S Rigel
OBJECTIVE: Risk prediction models for primary malignant melanoma thus far have relied on qualitative patient information. The authors propose a quantitative diagnostic predictive probability model using Multispectral Digital Skin Lesion Analysis for melanoma and other high-risk pigmented lesions and evaluate its effectiveness optimizing biopsy decisions by dermatologists. DESIGN: Data from 1,632 pigmented lesions analyzed by a Multispectral Digital Skin Lesion Analysis device were used to perform a logistic regression analysis...
December 2014: Journal of Clinical and Aesthetic Dermatology
Mark C Mochel, Lyn M Duncan, Adriano Piris, Stefan Kraft
Sinonasal mucosal melanoma is a rare disease with poor survival. These tumors may have associated intraepithelial melanocytic proliferations, which are not extensively characterized. This retrospective analysis of 32 patients with sinonasal mucosal melanoma examined associated intraepithelial melanocytic proliferations in the context of diagnostic and prognostic features. Patient age ranged from 30 to 90 years (median 71) with a male to female ratio of approximately 3:2. Follow up for 31 patients ranged from 5 to 211 months (mean 42 months)...
June 2015: Head and Neck Pathology
J Noelle Buonaccorsi, Victor G Prieto, Carlos Torres-Cabala, Saul Suster, Jose A Plaza
The histologic assessment of intraepidermal melanocytic proliferations involving sun-damaged skin may be challenging in scant biopsy material. Melanoma in situ may occasionally be confused with intraepidermal melanocytic hyperplasia on sun-damaged skin; thus, dermatopathologists may use immunohistochemical studies to help distinguish these entities. Historically, melanoma antigen recognized by T-cells 1 (MART-1) has been regarded as a valuable stain to confirm intraepidermal melanocytes; however, MART-1 may overestimate the number of melanocytes because it labels the melanoma dendrites and might also label pigmented keratinocytes, including structures mimicking junctional melanocytic nests in the setting of a lichenoid infiltrate...
February 2014: American Journal of Dermatopathology
T Krenacs, G Kiszner, E Stelkovics, P Balla, I Teleki, I Nemeth, E Varga, I Korom, T Barbai, V Plotar, J Timar, E Raso
The 180 kDa transmembrane collagen XVII is known to anchor undifferentiated keratinocytes to the basement membrane in hemidesmosomes while constitutively shedding a 120 kDa ectodomain. Inherited mutations or auto-antibodies targeting collagen XVII cause blistering skin disease. Collagen XVII is down-regulated in mature keratinocytes but re-expressed in skin cancer. By recently detecting collagen XVII in melanocyte hyperplasia, here we tested its expression in benign and malignant melanocytic tumors using endodomain and ectodomain selective antibodies...
October 2012: Histochemistry and Cell Biology
A Agustí-Mejias, F Messeguer Badia, R García Ruiz, V Oliver Martínez, V Alegre de Miquel
BACKGROUND: Atypical lentiginous nevus (of the elderly) is a peculiar form of dysplastic nevus. Clinically, this condition can resemble malignant melanoma and histologically, it has a lentiginous pattern with variable degrees of atypia and an absence of dermal nests. These features may lead to an erroneous diagnosis of lentigo maligna melanoma or lentiginous melanoma. MATERIAL AND METHODS: We reviewed 14 cases of atypical lentiginous nevus diagnosed at the dermatology department of Hospital General de Valencia in Valencia, Spain between December 2007 and March 2009...
June 2012: Actas Dermo-sifiliográficas
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