Difference between revisions of "Melanocytic lesions"

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==Spitz nevus==
==Spitz nevus==
*[[AKA]] ''epithelioid and spindle-cell nevus''.
*[[AKA]] ''epithelioid and spindle-cell nevus''.
 
{{Main|Spitz nevus}}
===General===
*May be very difficult to differentiate from [[melanoma]].
 
Epidemiology:
*Children & adolescents.
 
Treatment:
*Complete excision.<ref name=pmid12140468>{{Cite journal  | last1 = Gelbard | first1 = SN. | last2 = Tripp | first2 = JM. | last3 = Marghoob | first3 = AA. | last4 = Kopf | first4 = AW. | last5 = Koenig | first5 = KL. | last6 = Kim | first6 = JY. | last7 = Bart | first7 = RS. | title = Management of Spitz nevi: a survey of dermatologists in the United States. | journal = J Am Acad Dermatol | volume = 47 | issue = 2 | pages = 224-30 | month = Aug | year = 2002 | doi =  | PMID = 12140468 }}</ref>
 
===Gross===
*Usually face ''or'' extremity.<ref name=Ref_Derm449>{{Ref Derm|449}}</ref>
 
===Microscopic===
Features:<ref name=Ref_WMSP499>{{Ref WMSP|499}}</ref>
*Architecture:
**Nests of cells (spindle, epithelioid or spindle/epithelioid) - in both dermis and epidermis.
***Nests are vertically arranged, i.e. the long axis of the nests are perpendicular to the skin surface.
****Nest arrangement/orientation described as "cluster of bananas".
*+/-Hyperkeratosis (more keratin, i.e. thick stratum corneum).
*+/-Hypergranulosis (thick stratum granulosum).
*+/-[[Acanthosis]] (thick stratum spinosum).
*Kamino bodies (also written ''Camino bodies'') - dense eosinophilic bodies.<ref name=PMC2797485>{{Cite journal  | last1 = Kirkwood | first1 = John M. | last2 = Jukic | first2 = Drazen | last3 = Averbook | first3 = Bruce J. | last4 = Sender | first4 = Leonard S. | title = Melanoma in Pediatric, Adolescent, and Young Adult Patients | journal = Semin Oncol. | volume = 36 | issue = 5 | pages = 419-31 | month = October | year = 2009 | doi =  | PMID =  | URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797485/?tool=pmcentrez |PMC = 2797485 }}</ref>
**Apoptotic cells.
**Kamino bodies are rare in melanoma.
 
Notes:
*'''Never''' in the setting of [[solar elastosis]].<ref>Jakubovic, H. 16 July 2010.</ref>
**If there is solar elastosis -- it's melanoma.
 
DDx:
*[[Malignant melanoma]] - so-called ''Spitzoid melanoma''.
*[[Pigmented spindle cell nevus of Reed]].
 
====Images====
<gallery>
Image:Spitz_nevus_-_low_mag.jpg | Spitz nevus - low mag. (WC)
Image:Spitz_nevus_-_intermed_mag.jpg | Spitz nevus - intermed. mag. (WC)
Image:Spitz_nevus_-_high_mag.jpg | Spitz nevus - high mag. (WC)
</gallery>
www:
*[http://www.drmihm.com/cases/case.cfm?CaseID=51 Spitz nevus - collection of images (drmihm.com)].
*[http://alf3.urz.unibas.ch/pathopic/e/getpic-fra.cfm?id=006734 Spitz nevus with arrow to camino body (unibas.ch)].
 
===IHC===
*HMB-45 -ve at deep aspect.
*Ki-67 low.


==Acral nevus==
==Acral nevus==
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