Difference between revisions of "Acral nevus"
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*Palms ''or'' soles. | *Palms ''or'' soles. | ||
*May be confused with [[malignant melanoma]].<ref name=pmid19318796>{{Cite journal | last1 = Massi | first1 = G. | last2 = Vellone | first2 = VG. | last3 = Pagliarello | first3 = C. | last4 = Fabrizi | first4 = G. | title = Plantar melanoma that mimics melanocytic nevi: a report of 4 cases with lymph node metastases and with review of positive and negative controls. | journal = Am J Dermatopathol | volume = 31 | issue = 2 | pages = 117-31 | month = Apr | year = 2009 | doi = 10.1097/DAD.0b013e318194c904 | PMID = 19318796 }}</ref> | *May be confused with [[malignant melanoma]].<ref name=pmid19318796>{{Cite journal | last1 = Massi | first1 = G. | last2 = Vellone | first2 = VG. | last3 = Pagliarello | first3 = C. | last4 = Fabrizi | first4 = G. | title = Plantar melanoma that mimics melanocytic nevi: a report of 4 cases with lymph node metastases and with review of positive and negative controls. | journal = Am J Dermatopathol | volume = 31 | issue = 2 | pages = 117-31 | month = Apr | year = 2009 | doi = 10.1097/DAD.0b013e318194c904 | PMID = 19318796 }}</ref> | ||
**>45 years old with a "compound nevus"... consider melanoma.<ref name=pmid19318796/> | |||
Note: | 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> | *''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> | ||
Revision as of 15:20, 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]
- >45 years old with a "compound nevus"... consider 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 1.3 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.