Difference between revisions of "Acral nevus"

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#redirect [[Melanocytic_lesions#Acral_nevus]]
'''Acral nevus''', also '''volar nevus''', is a benign [[Melanocytic lesions|melanocytic lesion]] of the palm or sole.
 
''Melanocytic nevus with intraepidermal ascent of cells'' (abbreviated ''MANIAC'') redirect to here.
 
==General==
*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]].
 
==See also==
*[[Melanocytic lesions]].
 
==References==
{{Reflist|1}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Melanocytic lesions]]

Revision as of 14:13, 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) redirect to here.

General

  • Palms or soles.

Note:

  • Volar refers to the palmar aspect or plantar aspect.[1]

Gross

  • Pigmented lesion.

Note:

  • Should be bisected perpendicular to the dermatoglyphs (ridges).[2]
    • 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.[2]

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".[2]

DDx:

See also

References

  1. URL: http://www.medterms.com/script/main/art.asp?articlekey=9907. Accessed on: 14 January 2013.
  2. 2.0 2.1 2.2 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.