Literature Update on Melanocytic Nevi and Pigmented Lesions in the Pediatric Population

Background: The relationship between pregnancy and a change in melanocytic nevi is still controversial. Moreover, management of the rapid evolution of a nevus in an unauspicious melanocytic lesion can be a clinical challenge in pregnancy. Methods: This article examines a case of a fast-growing deep penetrating nevus in a pregnant woman and provides a literature review of articles relative to pregnancy and nevi change, the management of fast-growing pigmented lesions, and the role and usefulness of dermoscopy in these cases. Results: Recent studies have documented that pregnancy is not associated with any significant change in the size of melanocytic nevi. The management of fast-growing melanocytic lesions during this period compulsorily leans toward excision. Dermoscopy can be useful, providing clinicohistopathologic correlations and a better assignment of the lesion. Conclusion: This case report and review provide important management considerations for nevi during pregnancy. Early intervention with aggressive treatment measures is the best management for fast-growing lesions, and epiluminescence dermoscopy can assist the management, although still remaining a second-level examination, useful for documentation and for a better classification of the lesion.

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DERMOSCOPY OF THE MONTH Nevi with Site-Related Atypia

Serbian Journal of Dermatology and Venerology ◽

10.1515/sjdv-2017-0020 ◽

2017 ◽

Vol 9 (4) ◽

pp. 169-173

Author(s):

Tanja Tirnanić ◽

Dimitrije Brašanac ◽

Lidija Kandolf Sekulović

Keyword(s):

Histological Features ◽

Melanocytic Nevi ◽

Pigmented Lesions ◽

Anatomic Locations ◽

Benign Nevi ◽

Present Site

Abstract The term “nevi of special sites” refers to melanocytic nevi of specific anatomic locations including the breast, axillae, umbilicus, genitalia, flexural areas, acral surfaces, ear, scalp and the conjunctiva. Nevi from these anatomic sites display sometimes dermoscopic and histological features of melanoma, resulting in unnecessarily high rates of excisions and re-excisions. Some authors have categorized nevi excised in the axillary, breast, umbilical and perineal areas as the nevi of the milk line. Two patients, a 32-year-old female and 23-year-old male with breast and periumbilical pigmented lesions, presented to our Department during 2017. Dermoscopy revealed features that were highly specific for melanoma. Excisional biopsies were done and histopathology revealed benign nevi with present site-related atypia. Irregular blotches, non-uniform radial streaks, blue-gray veil, and regression are the most specific features of melanoma of the breast and flexural areas. Excision is always recommended in pigmented lesions on the breast and flexural areas, which exhibit these features. However, larger studies are needed to define specific criteria required to distinguish special-site nevi from melanoma.

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Melanocortin-1 receptor (MC1R) genotypes do not correlate with size in two cohorts of medium-to-giant congenital melanocytic nevi

10.1101/2020.04.10.20055301 ◽

2020 ◽

Author(s):

Neus Calbet-Llopart ◽

Mirella Pascini-Garrigos ◽

Gemma Tell-Martí ◽

Miriam Potrony ◽

Vanessa Martins da Silva ◽

...

Keyword(s):

Epidemiological Studies ◽

Compound Heterozygous ◽

Control Analysis ◽

Large Set ◽

Adult Size ◽

Loss Of Function ◽

Melanocytic Nevi ◽

Pigmented Lesions ◽

Congenital Melanocytic Nevi

ABSTRACTCongenital melanocytic nevi (CMN) are cutaneous malformations whose prevalence is inversely correlated with projected adult size. CMN are caused by somatic mutations, but epidemiological studies suggest that germline genetic factors may influence CMN development. In CMN patients from the U.K., genetic variants in the MC1R gene, such as p.V92M and loss-of-function variants, have been previously associated with larger CMN. We analyzed the association of MC1R variants with CMN characteristics in 113 medium-to-giant CMN patients from Spain and from a distinct cohort of 53 patients from France, Norway, Canada and the U.S. These cohorts were similar at the clinical and phenotypical level, except for the number of nevi per patient. We found that the p.V92M or loss-of-function MC1R variants either alone or in combination did not correlate with CMN size, in contrast to the U.K. CMN patients. An additional case-control analysis with 259 unaffected Spanish individuals, showed a higher frequency of MC1R compound heterozygous or homozygous variant genotypes in Spanish CMN patients compared to the control population (15.9% vs. 9.3%; P=0.075). Altogether, this study suggests that MC1R variants are not associated with CMN size in these non-U.K. cohorts. Additional studies are required to define the potential role of MC1R as a risk factor in CMN development.SIGNIFICANCECongenital melanocytic nevi (CMN) are common pigmented lesions that originate during prenatal life, without clear evidence of a genetic predisposition. To date, limited data exist regarding the role of the MC1R gene, a key regulator of human pigmentation, in the development of the class of rarer CMN that are greater than 10 cm diameter at projected adult size and associated with increased morbidity or mortality risks. This study provides data from a large set of such CMN patients to support the hypothesis that MC1R could be involved in the development of these types of lesions, but at the same time discounting its influence on the size of CMN across distinct populations. Improving our understanding of genetic susceptibility to rare types of CMN is necessary to determine whether routine germline genotyping is relevant in clinical practice.

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Correlation between dermoscopic and histopathological diagnoses of atypical nevi in a dermatology outpatient clinic of the Medical School of São José do Rio Preto, SP, Brazil

Anais Brasileiros de Dermatologia ◽

10.1590/s0365-05962013000200002 ◽

2013 ◽

Vol 88 (2) ◽

pp. 199-203 ◽

Cited By ~ 6

Author(s):

João Roberto Antonio ◽

Rosa Maria Cordeiro Soubhia ◽

Solange Corrêa Garcia Pires D'Avila ◽

Adriana Cristina Caldas ◽

Lívia Arroyo Trídico ◽

...

Keyword(s):

Outpatient Clinic ◽

Skin Lesions ◽

Histopathological Diagnosis ◽

Melanocytic Nevi ◽

Pigmented Lesions ◽

Highly Sensitive ◽

Advanced Stages ◽

Malignant Lesions ◽

Atypical Nevi

BACKGROUND: The incidence of cutaneous melanoma is increasing worldwide. Since it is an aggressive neoplasm, it is difficult to treat in advanced stages; early diagnosis is important to heal the patient. Melanocytic nevi are benign pigmented skin lesions while atypical nevi are associated with the risk of developing melanoma because they have a different histological pattern than common nevi. Thus, the clinical diagnosis of pigmented lesions is of great importance to differentiate benign, atypical and malignant lesions. Dermoscopy appeared as an auxiliary test in vivo, playing an important role in the diagnosis of pigmented lesions, because it allows the visualization of structures located below the stratum corneum. It shows a new morphological dimension of these lesions to the dermatologist and allows greater diagnostic accuracy. However, histopathology is considered the gold standard for the diagnosis. OBJECTIVES: To establish the sensitivity and specificity of dermoscopy in the diagnosis of pigmented lesions suspected of malignancy (atypical nevi), comparing both the dermatoscopic with the histopathological diagnosis, at the Dermatology Service of the outpatient clinic of Hospital de Base, São José do Rio Preto, SP. METHODS: Analysis of melanocytic nevi by dermoscopy and subsequent biopsy on suspicion of atypia or if the patient so desires, for subsequent histopathological diagnosis. RESULTS: Sensitivity: 93%. Specificity: 42%. CONCLUSIONS: Dermoscopy is a highly sensitive method for the diagnosis of atypical melanocytic nevi. Despite the low specificity with many false positive diagnoses, the method is effective for scanning lesions with suspected features of malignancy.

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Congenital melanocytic nevus of the oral mucosa: report of a rare pigmented lesion and review of the literature

Clinics and Practice ◽

10.4081/cp.2011.e17 ◽

2011 ◽

Vol 1 (1) ◽

pp. 17 ◽

Cited By ~ 4

Author(s):

Melanie Louise Gilbert ◽

Weddad Hanna ◽

Danny Ghazarian ◽

Dean Dover ◽

Hagen Benjamin Edward Klieb

Keyword(s):

Oral Mucosa ◽

Melanocytic Nevus ◽

Congenital Melanocytic Nevus ◽

Review Of The Literature ◽

Melanocytic Nevi ◽

Pigmented Lesions ◽

Pigmented Lesion ◽

Congenital Melanocytic Nevi

Oral pigmented lesions are uncommon and congenital melanocytic nevi are especially rare. We report a case of a patient with multiple congenital melanocytic nevi including a palatal lesion. This is reported to add to the scant literature that exists on this subject. Prognosis and management are discussed.

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Eruptive Melanocytic Nevi Induced by Interferon for Nodal Metastatic Melanoma: Case Report and Review of the Literature

Journal of Cutaneous Medicine and Surgery ◽

10.2310/7750.2013.13034 ◽

2013 ◽

Vol 17 (6) ◽

pp. 410-413 ◽

Cited By ~ 4

Author(s):

Thomas G. Salopek ◽

Muhammad N. Mahmood

Keyword(s):

Nodal Metastasis ◽

Chemotherapeutic Agents ◽

High Dose ◽

Melanocytic Nevi ◽

Dysplastic Nevi ◽

Pigmented Lesions ◽

Paraneoplastic Disorder ◽

Possible Cause ◽

High Dose Interferon ◽

Melanoma Case

Background: The rapid appearance of multiple new melanocytic nevi is known as eruptive nevi and has been well documented to occur with certain medications, in particular chemotherapeutic agents. Methods: We report a case of a woman with melanoma complicated by nodal metastasis who developed multiple melanocytic nevi while on high-dose interferon. Results: Serial photographs confirmed that the pigmented lesions were of new onset, whereas histology documented that the lesions were dysplastic nevi. A survey of the literature documented numerous causes of eruptive nevi, which we review. To date, interferon has not been linked to eruptive nevi. Conclusions: The phenomenon of eruptive nevi has been attributed to medications, bullous dermatoses, immunosuppression, and systemic conditions and is possibly a paraneoplastic disorder. Interferon appears to be another possible cause of this disorder.

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Cutaneous pigmented lesions not related to melanocytic nevi or melanoma

Pathology of Melanocytic Disorders 2ed ◽

10.1201/b13561-15 ◽

2007 ◽

pp. 239-262

Keyword(s):

Melanocytic Nevi ◽

Pigmented Lesions

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A Case of Blue Nevus of Posterior Wall of Pharynx

Korean Journal of Otorhinolaryngology - Head and Neck Surgery ◽

10.3342/kjorl-hns.2019.00626 ◽

2020 ◽

Vol 63 (4) ◽

pp. 180-182

Author(s):

Jun Young Lee ◽

Sun Wook Kim ◽

Hyo Geun Choi ◽

Bum Jung Park

Keyword(s):

Oral Cavity ◽

Posterior Wall ◽

Melanocytic Nevus ◽

The Body ◽

Blue Nevus ◽

Pharyngeal Wall ◽

Melanocytic Nevi ◽

Pigmented Lesions ◽

Pigmented Lesion ◽

Mucous Membranes

Menalocytic nevi are benign localized pigmented lesions, which usually occur on the cutaneous surface of the body but rarely on the mucous membranes. It is comparatively easy to encounter pigmented lesions of the oral cavity, but the melanocytic nevi of the pharyngeal wall are extremely rare worldwide and, to the best of our knowledge, there is no reported case of melanocytic nevus arising from pharyngeal wall. We report a case of a pigmented lesion on the posterior wall of pharynx, which was microscopically confirmed as oropharyngeal blue nevus.

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Age and Anatomical Location–Related Dermoscopic Patterns of 210 Acral Melanocytic Nevi in a Turkish Population

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475417712496 ◽

2017 ◽

Vol 21 (5) ◽

pp. 388-394 ◽

Cited By ~ 1

Author(s):

Nazan Emiroglu ◽

Fatma Pelin Cengiz ◽

Nahide Onsun

Keyword(s):

Pediatric Population ◽

Turkish Population ◽

Descriptive Study ◽

Anatomical Location ◽

Inclusion Criteria ◽

Benign Lesions ◽

Common Pattern ◽

Melanocytic Nevi ◽

Observational Descriptive Study ◽

Study Inclusion

Background: Dermoscopy is a useful tool for earlier diagnosis and differentiating benign lesions from melanoma. Objectives: We aim to investigate dermoscopic features of acral nevi, age, and localisation-related findings of these lesions. Methods: This was an observational, descriptive study. Patients were retrospectively collected from the Department of Dermatology. The patients with acral nevi were included in the study. Inclusion criteria were Turkish nationality and the presence of at least 1 acral nevus diagnosed both clinically and dermoscopically. Lesions in dorsal and subungual areas were excluded. All nevi were examined by the same dermatologist. Results: The most common dermoscopic patterns were as follows: parallel furrow (87 patients; 41.4%), globular (24 patients; 11.4%), fibrillar (22 patients; 10.5%), combination patterns (19 patients; 9.1%), globulostreak-like (16 patients; 7.6%), lattice-like (15 patients; 7.1%), homogeneous (12 patients; 5.7%), nontypical (8 patients; 3.8%), parallel ridge (4 patients; 1.9%), reticular (2 patients; 1.0%), and crista dotted pattern (1 patient; 0.5%). The parallel furrow pattern was the most common pattern in all localisations. The number of parallel furrow patterns (5 lesions) was equal to the globulostreak-like pattern (5 lesions) on the thenar area. The number of parallel furrow patterns (4 lesions) was equal to the fibrillar pattern (4 lesions) on the heel. Parallel furrow (dotted variants) (11 lesions) and globulostreak-like patterns (5 lesions) were the most common patterns in the pediatric population (0-15 years old). The fibrillar pattern showed a tendency for soles (12 lesions), while a lattice-like pattern was seen more often in the plantar arch (3 lesions). Conclusions: Description of the dermoscopic features of acral nevi is important to improve management and reduce the number of unnecessary excisions. The most common patterns were parallel furrow, globular, and fibrillar in our study. Parallel furrow (dotted variants) and globulostreak-like patterns were the most common patterns in the pediatric population. The fibrillar pattern showed a tendency for soles, while a lattice-like pattern was seen more often on the plantar arch. Therefore, there may be a relation between anatomic localisation, age, and dermoscopic pattern.

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The Incidence of Birthmarks in the Neonate

PEDIATRICS ◽

10.1542/peds.58.2.218 ◽

1976 ◽

Vol 58 (2) ◽

pp. 218-222 ◽

Cited By ~ 3

Author(s):

Alvin H. Jacobs ◽

Robert G. Walton

Keyword(s):

Newborn Infants ◽

Port Wine ◽

Port Wine Stains ◽

Melanocytic Nevi ◽

Pigmented Lesions

The presence of various types of birthmarks was determined in 1,058 newborn infants under 72 hours of age. Of these, 79.5% were white, 6.2% were black, 11.2% were ladinos, and 2.6% were Asiatic. Mongol spots were present in 9.6% of the white babies, 95.5% of the black babies, 81% of the Asiatic babies, and 70.1% of ladino infants. Pigmented lesions were present in 42 (4%) of the infants. Biopsies obtained in 34 (3.2%) revealed that only one-third (11) of these were melanocytic nevi. Salmon patches were present in 40.3% of the infants, recognizable early strawberry marks in 2.6%, and port-wine stains in 0.3%. In addition to birthmarks, it was determined that 30.3% of the 508 babies examined at one of the two hospitals had toxic erythema of the newborn.

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