Acral nevus
Jump to navigation
Jump to search
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:
- Acral lentiginous melanoma.
See also
References
- ↑ URL: http://www.medterms.com/script/main/art.asp?articlekey=9907. Accessed on: 14 January 2013.
- ↑ 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.