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Difference between revisions of "Acral nevus"
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'''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]] | |||