1
|
Abstract
Eruptive melanocytic nevi (EMN) is a phenomenon characterized by the sudden onset of nevi. Our objective was to compile all published reports of EMN to identify possible precipitating factors and to evaluate the clinical appearance and course. We conducted a systematic bibliographic search and selected 93 articles, representing 179 patients with EMN. The suspected causes were skin and other diseases (50%); immunosuppressive agents, chemotherapy or melanotan (41%); and miscellaneous, including idiopathic (9%). The clinical manifestations could largely be divided into two categories: EMN associated with skin diseases were frequently few in number (fewer than ten nevi), large, and localized to the site of previous skin disease, whereas those due to other causes presented most often with multiple small widespread nevi. In general, EMN seem to persist unchanged after their appearance, but development over several years or fading has also been reported. Overall, 16% of the cases had at least one histologically confirmed dysplastic nevus. Five cases of associated melanoma were reported. We conclude that the clinical appearance of EMN may differ according to the suggested triggering factor. Based on the clinical distinction, we propose a new subclassification of EMN: (1) widespread eruptive nevi (WEN), with numerous small nevi, triggered by, for example, drugs and internal diseases, and (2) Köbner-like eruptive nevi, often with big and few nevi, associated with skin diseases and most often localized at the site of previous skin disease/trauma. The nature of the data precluded assessment of risk of malignant transformation.
Collapse
|
2
|
Katoulis AC, Sgouros D, Argenziano G, Rallis E, Panayiotides I, Rigopoulos D. Surgical suturing-induced melanocytic nevi. A new type of eruptive melanocytic nevi? J Dermatol Case Rep 2016; 10:49-52. [PMID: 28400894 DOI: 10.3315/jdcr.2016.1233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 09/04/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND Nevogenesis is a complex process involving several pathogenetic mechanisms, including genetic factors, hormonal influences and UV-radiation. Trauma has been described as a triggering factor for an alternative pathway of nevogenesis. Eruptive melanocytic nevi (EMN), related either to immunosuppression or to blistering disorders, represent a special type of nevi probably induced by the disruption of the dermo-epidermal junction and consequent proliferation of quiescent pigment cells during re-epithelization. MAIN OBSERVATIONS We report two patients with three melanocytic nevi that developed de novo along the direction of surgical suturing, following surgical operation for other reason. The lesions exhibited special dermoscopic characteristics and histology revealed features of acquired melanocytic nevi. CONCLUSIONS Such cases may represent a new type of eruptive nevus, the surgical suturing-induced nevus, which should be included in the differential diagnosis of new pigmentation developing within a scar.
Collapse
Affiliation(s)
- Alexander C Katoulis
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, 1 Rimini str, 12462, Chaidari, Athens, Greece
| | - Dimitrios Sgouros
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, 1 Rimini str, 12462, Chaidari, Athens, Greece
| | - Giuseppe Argenziano
- Dermatology Unit, 2nd University of Naples, 43 Antonio Vivaldi str, 81100, Caserta CE, Naples, Italy
| | - Efstathios Rallis
- Department of Dermatology, Veterans Administration Hospital, 10 Monis Petraki str, 11521, Athens, Greece
| | - Ioannis Panayiotides
- 2nd Department of Pathology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, 1 Rimini str, 12462, Chaidari, Athens, Greece
| | - Dimitrios Rigopoulos
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, 1 Rimini str, 12462, Chaidari, Athens, Greece
| |
Collapse
|
3
|
Mazaud C, Chevallier B, Sigal ML, Mahé E. [Childhood eruptive nevi: a case report]. Arch Pediatr 2015; 22:409-13. [PMID: 25725971 DOI: 10.1016/j.arcped.2015.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 10/29/2014] [Accepted: 01/20/2015] [Indexed: 10/23/2022]
Abstract
"Eruptive nevi" is a phenomenon characterized by a rapid appearance of multiple melanocytic nevi. It is mainly developed in three groups of patients: those with systemic immunosuppression, bullous cutaneous disorders, and a melanocytic stimulation drug. We report on the case of an 11-year-old boy who was diagnosed with acute lymphoblastic leukemia. A few months after the beginning of the chemotherapy, he developed multiple pigmented lesions over the skin. Eruptive nevi syndrome has been described in the literature in 29 cases in the context of severe bullous disease and in immunosuppression. Nevi most often appear on the trunk and extremities, notably on the feet in the context of immunosuppression. They are localized in areas of bullous lesions in bullous diseases. Due to an increased melanocytic stimulation in eruptive nevi patients, long-term surveillance of individuals who have developed eruptive nevi is required, and increased sun prevention should be suggested.
Collapse
Affiliation(s)
- C Mazaud
- Service de dermatologie, hôpital Victor-Dupouy, 69, rue du Lieutenant Colonel Prudhon, 95100 Argenteuil, France
| | - B Chevallier
- Service de pédiatrie, université Versailles-SQY, hôpital Ambroise-Paré, Assistance publique-Hôpitaux de Paris, 9, avenue du Général-de-Gaulle, 92100 Boulogne-Billancourt, France
| | - M-L Sigal
- Service de dermatologie, hôpital Victor-Dupouy, 69, rue du Lieutenant Colonel Prudhon, 95100 Argenteuil, France
| | - E Mahé
- Service de dermatologie, hôpital Victor-Dupouy, 69, rue du Lieutenant Colonel Prudhon, 95100 Argenteuil, France.
| |
Collapse
|
4
|
Epidermolysis bullosa nevus in a patient with recessive dystrophic epidermolysis bullosa: a case report. Am J Dermatopathol 2014; 36:e194-7. [PMID: 25051104 DOI: 10.1097/dad.0000000000000059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We present a case of a 6-year-old girl with recessive dystrophic epidermolysis bullosa (EB) who presented with a large pigmented lesion clinically concerning for melanoma. After histological examination and fluorescent in situ hybridization analysis, diagnosis of EB nevus was performed. EB nevi are benign melanocytic neoplasms with histological findings similar to recurrent nevi occurring in all types of EB. They often mimic melanoma clinically, dermatoscopically, and histopathologically. The ability to recognize an EB nevus is essential for appropriate management of the patient. Unnecessary surgical excision in patients with already high-risk EB should be avoided. Close monitoring of these lesions is recommended because no cases of transformation to melanoma have been described.
Collapse
|
5
|
Fernandes JD, Rivitti-Machado MC, Nakano J, de Oliveira Rocha B, Oliveira ZNP. Clinical, dermoscopic and histopathological features of melanocytic nevi in dystrophic epidermolysis bullosa. J Dtsch Dermatol Ges 2014; 12:237-42, 237-43. [DOI: 10.1111/ddg.12258] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 10/23/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Juliana Nakano
- Department of Dermatology; University of São Paulo. São Paulo; São Paulo Brazil
| | | | | |
Collapse
|
6
|
Miquel J, Chevrant-Breton J, Dupuy A, Le Gall F, Bourdon-Lannoy E, Adamski H, Bodemer C. [Eruptive naevi in epidermolysis bullosa hereditaria patients]. Ann Dermatol Venereol 2012; 139:435-43. [PMID: 22721475 DOI: 10.1016/j.annder.2012.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 01/18/2012] [Accepted: 03/16/2012] [Indexed: 01/10/2023]
Abstract
BACKGROUND EB naevus (EBN) are little-known, atypical, eruptive, pigmented melanocytic lesions that may occur in former sites of bullae occurring in epidermolysis bullosa hereditaria (EBH). We sought to describe the characteristics of such lesions and assess their course. PATIENTS AND METHODS This was a retrospective, two-centre study in which data was collated from the medical files of patients with EBN. We analyzed the patients' demographical data as well as the clinical, dermatoscopic, pathological features of EBN and their progression. RESULTS Eight patients were studied: they were principally Caucasian (5/8), with a sex ratio of 1. All variants of EBH were represented and most were recessive (63%). We analysed 22 EBN, all atypical and emerging before the age of 10 years (73%), ubiquitously distributed and measuring greater than 5 cm(2) (25%). Of the 13 EBN subjected to dermatoscopy, 12 exhibited a benign reticular pattern. Four were biopsied, and analysis revealed three common naevi and one lentigo. After a median follow-up of 8 years, the EBN seen were either stable (68%), had regressed (23%) or had disappeared (one case). No cases of melanoma were diagnosed. DISCUSSION EBN are acquired and atypical pigmented naevi. Sixty-four cases of EBN have been reported in the literature up to date. The dermatoscopic features may be evocative of melanoma (17/23 EBN), but to our knowledge no cases of melanoma at a naevus site have been reported. Recessive transmission of EBH appears to be a risk factor (63% of cases), a finding supported by certain pathophysiological hypotheses. CONCLUSION EBN present atypical clinical and dermatoscopic features. However, while prophylactic total excision did not appear warranted in the absence of any reported cases of melanoma, regular clinical follow-up is recommended.
Collapse
Affiliation(s)
- J Miquel
- Service de dermatologie, hôpital Pontchaillou, CHU, 2, rue Henri-le-Guilloux, 35033 Rennes, France.
| | | | | | | | | | | | | |
Collapse
|
7
|
Cotrim CP, Simone FTD, Lima RB, Barcaui CB, Sousa MAJ, Lowy G. Epidermolysis bullosa nevus: case report and literature review. An Bras Dermatol 2011; 86:767-71. [PMID: 21987147 DOI: 10.1590/s0365-05962011000400023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Accepted: 07/12/2010] [Indexed: 11/21/2022] Open
Abstract
Acquired melanocytic lesions resembling malignant melanoma have been described in all major categories of Epidermolysis bullosa and referred to as "Epidermolysis bullosa nevi''. They easily induce to diagnostic error, although no malignant transformation has been reported. We report the development of a large acquired melanocytic nevus at a site of recurrent blisters in a 5-year-old child with Epidermolysis bullosa simplex. The global dermoscopic pattern was suggestive of benignity, and the histopathological findings were compatible with a compound melanocytic nevus. This is the first published case of Epidermolysis bullosa nevi in Brazilian literature. Despite their benign behavior, we emphasize the importance of regular clinical and dermoscopic monitoring, since a malignant course still cannot be totally excluded.
Collapse
Affiliation(s)
- Carolina Porto Cotrim
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro, Brasil.
| | | | | | | | | | | |
Collapse
|
8
|
Melo JND, Teruya PY, Machado MCR, Valente NS, Sotto MN, Oliveira ZNPD. Epidermolysis bullosa nevi: clinical, dermatoscopical and histological features in a case of recessive dystrofic form. An Bras Dermatol 2011; 86:743-6. [PMID: 21987141 DOI: 10.1590/s0365-05962011000400017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2005] [Accepted: 07/14/2010] [Indexed: 11/22/2022] Open
Abstract
Acquired melanocytic lesions may present unusual clinical features in all forms of hereditary epidermolysis bullosa. These lesions are known as "EB nevi", and often pose a diagnostic challenge for dermatologists given their resemblance - clinically, dermoscopically and histologically - to melanoma. The lesions have been reported in all types of hereditary EB, most of them in childhood. We report the case of a 6-month-old boy suffering from recessive dystrophic epidermolysis bullosa (RDEB) that presented as a large pigmented lesion on his left thigh. We decided to monitor the lesion closely since we considered that the clinical and pathological aspects of the lesion were compatible with the description of other previously reported cases of EB nevi.
Collapse
Affiliation(s)
- Juliana Nakano de Melo
- Departamento de Dermatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brasil.
| | | | | | | | | | | |
Collapse
|
9
|
|
10
|
Sugiyama-Fukamatsu H, Suzuki N, Nakanishi G, Iwatsuki K. Epidermolysis bullosa nevus arising in a patient with Dowling-Meara type epidermolysis bullosa simplex with a novel K5 mutation. J Dermatol 2009; 36:447-52. [PMID: 19691749 DOI: 10.1111/j.1346-8138.2009.00674.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We report herein a 4-year-old girl with Dowling-Meara type epidermolysis bullosa (EB) who presented with peculiar pigmented nevi. Blister formation had repeatedly occurred on the erythematous plaques in a circinate fashion since birth, and marked hyperkeratosis was observed on the palms and soles associated with nail deformity. Her mother and maternal grandmother also had similar symptoms. In addition to the blistering lesions, the patient had three large, asymmetrical, pigmented plaques with color variegation. Light and electron microscopic findings of the blistering lesions showed a subepidermal blister with intracytoplasmic granules in keratinocytes as well as degeneration of basal cells and aggregation of tonofilaments. The pigmented lesions revealed histopathological features of compound nevus without malignant changes. Gene analysis revealed an E478K (Glu to Lys) mutation in exon 5 of the keratin 5 (K5) gene. These findings, together with clinical features, were consistent with those of Dowling-Meara type EB associated with so-called EB nevus.
Collapse
Affiliation(s)
- Hiroko Sugiyama-Fukamatsu
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Phartmaceutical Sciences, Okayama, Japan
| | | | | | | |
Collapse
|
11
|
Abstract
The diagnosis of epidermotropic metastatic malignant melanoma (EMMM) can be extremely challenging for both clinicians and pathologists. The diffculties include distinguishing metastatic lesions with an epidermal component from residual incompletely excised primary melanoma, and multiple primary melanomas. This has great prognostic significance as the current American Joint Committee on Cancer guidelines consider localized metastatic disease such as satellites and intransits in the nodal (N) category of N2C or stage IIIB disease. In this report, we present a case of EMMM with angiotropism. Additionally, we discuss in detail the differential diagnosis for recurrence of malignant melanoma with an epidermal component within the scar. Angiotropism may be seen in lesions of EMMM and the current literature suggests that angiotropism is highly suggestive of metastatic melanoma. The differential diagnosis of locally recurrent melanoma with an epidermal component can be extremely challenging and the presence of angiotropism may be a clue to the diagnosis of EMMM.
Collapse
Affiliation(s)
- Pedram Gerami
- Department of Dermatology, Northwestern University, Chicago, IL 60611, USA.
| | | | | |
Collapse
|
12
|
Lebeau S, Braun RP, Masouyé I, Perrinaud A, Harms M, Borradori L. Acquired Melanocytic Naevus in Childhood Vulval Pemphigoid. Dermatology 2006; 213:159-62. [PMID: 16902297 DOI: 10.1159/000093859] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2005] [Accepted: 02/25/2006] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Eruptive epidermolysis bullosa (EB) naevi comprise a subset of melanocytic naevi with atypical features that characteristically occur in areas of former blistering in patients suffering from hereditary EB. OBSERVATION The case is reported of a girl who presented with pruritus, blistering and erosions of the vulval region. Clinical and immunopathological features were consistent with the diagnosis of childhood vulval pemphigoid. In the course of the disease, she developed an atypical melanocytic naevus on the left labium at a site of former blistering. Although its clinical and dermoscopic features resembled malignant melanoma, the lesion completely regressed clinically during the 24-month follow-up. CONCLUSION This is the first report describing the development of a melanocytic naevus at sites of blistering in an auto-immune subepidermal blistering disease in childhood. Our observation extends the spectrum of disorders, in addition to the group of congenital EB, in which 'eruptive' atypical melanocytic naevi may occur. Knowledge of this complication is important for appropriate management and follow-up and to avoid radical surgery.
Collapse
Affiliation(s)
- S Lebeau
- Clinic of Dermatology, University Hospital, Geneva, Switzerland
| | | | | | | | | | | |
Collapse
|
13
|
Bero SM, Busam KJ, Brady MS. Cutaneous melanoma arising in a burn scar: two recent cases and a review of the literature. Melanoma Res 2006; 16:71-6. [PMID: 16432459 DOI: 10.1097/01.cmr.0000194428.39525.87] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Melanoma arising in a burn scar is extremely uncommon. We report two recent cases, including one patient in whom six distinct primary melanomas arose in the setting of an extensive truncal burn scar. Only 27 patients have been reported previously, and only three previous cases of multiple primary melanomas arising in a burn scar have been described.
Collapse
|