Difference between revisions of "Melanocytic lesions"

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Melanocytic lesions (view source)

Revision as of 14:14, 8 September 2015

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*[[AKA]] ''melanocytic nevus with intraepidermal ascent of cells'' (MANIAC).
*[[AKA]] ''melanocytic nevus with intraepidermal ascent of cells'' (MANIAC).
*[[AKA]] ''volar nevus''.
*[[AKA]] ''volar nevus''.
===General===
{{Main|Acral nevus}}
*Palms ''or'' soles.
 
Note:
*''Volar'' refers to the palmar aspect ''or'' plantar aspect.<ref>URL: [http://www.medterms.com/script/main/art.asp?articlekey=9907 http://www.medterms.com/script/main/art.asp?articlekey=9907]. Accessed on: 14 January 2013.</ref>
 
===Gross===
*Pigmented lesion.
 
Note:
*Should be bisected perpendicular to the dermatoglyphs (ridges).<ref name=pmid22703907/>
**Lesions sectioned parallel to the ridges (on microscopy) may appear to have confluent junctional nests (leading to the diagnosis of melanoma).
===Microscopic===
Features:
*Acral skin:
**Thick stratum corneum (hyperkeratotic).
**Thick stratum spinosum (acanthotic).
*Nevus with intraepidermal ascent of cells.
**May be referred to as ''Pagetoid scatter''.
**Should '''not''' be present at the edge of the lesion - '''key feature'''.<ref name=pmid22703907/>
 
Notes:
*Intraepidermal ascent of cells is usually suggestive of melanoma.
**In acral sites (esp. at the centre of a lesion) the criteria are relaxed, i.e. this is considered benign for this site.
*Nests in the ridges raise the suspicion of melanoma.
**Memory device "ridges are risky, furrows are fine".<ref name=pmid22703907>{{Cite journal  | last1 = Elston | first1 = D. | title = Practical advice regarding problematic pigmented lesions. | journal = J Am Acad Dermatol | volume = 67 | issue = 1 | pages = 148-55 | month = Jul | year = 2012 | doi = 10.1016/j.jaad.2012.04.006 | PMID = 22703907 }}</ref>
 
DDx:
*Acral lentiginous [[melanoma]].


==Dysplastic melanocytic nevus==
==Dysplastic melanocytic nevus==
Michael
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