Difference between revisions of "Acral nevus"
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*Nests in the ridges raise the suspicion of melanoma. | *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> | **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> | ||
*Large (diameter) lesions (>10 mm) should prompt consideration of melanoma.<ref name=pmid19318796/> | |||
*Depth >1 mm should prompt consideration of melanoma.<ref name=pmid19318796/> | |||
DDx: | DDx: | ||
Revision as of 15:18, 8 September 2015
Acral nevus, also volar nevus, is a benign melanocytic lesion of the palm or sole.
Melanocytic nevus with intraepidermal ascent of cells (abbreviated MANIAC) redirects to here.
General
- Palms or soles.
- May be confused with malignant melanoma.[1]
Note:
- Volar refers to the palmar aspect or plantar aspect.[2]
Gross
- Pigmented lesion - usually small.
Grossing note:
- Should be bisected perpendicular to the dermatoglyphs (ridges).[3]
- 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.[3]
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".[3]
- Large (diameter) lesions (>10 mm) should prompt consideration of melanoma.[1]
- Depth >1 mm should prompt consideration of melanoma.[1]
DDx:
- Acral lentiginous melanoma.
See also
References
- ↑ 1.0 1.1 1.2 Massi, G.; Vellone, VG.; Pagliarello, C.; Fabrizi, G. (Apr 2009). "Plantar melanoma that mimics melanocytic nevi: a report of 4 cases with lymph node metastases and with review of positive and negative controls.". Am J Dermatopathol 31 (2): 117-31. doi:10.1097/DAD.0b013e318194c904. PMID 19318796.
- ↑ URL: http://www.medterms.com/script/main/art.asp?articlekey=9907. Accessed on: 14 January 2013.
- ↑ 3.0 3.1 3.2 Elston, D. (Jul 2012). "Practical advice regarding problematic pigmented lesions.". J Am Acad Dermatol 67 (1): 148-55. doi:10.1016/j.jaad.2012.04.006. PMID 22703907.