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Dermatology Images

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DermAtlas: Histology - nevus, acral
© 2001-2009, DermAtlas
Image Name: acral_nevus_1_090401   File Type: jpg
Diagnosis: NEVUS, ACRAL /
NEVUS, PIGMENTED /
NEVUS, PIGMENTED, ATYPICAL
  Category: neoplasm, melanocytic /
neoplasm, benign
Body Site: toe   Age: 33 years
Contributor: Greg Hosler, MD, PhD    
Description: Histologic sections are of acral skin. There is a fairly symmetric cellular lesion involving the epidermis and dermis.
Comments: This 33 year old woman presented with a pigmented papule on her 3rd toe. It was biopsied to rule out melanoma. Acral nevi are a subset of melanocytic nevocellular nevi, which can have atypical clinical and histologic findings, but are benign. Clinically, the lesions often have irregular but sharp borders, likely due to the presence of dermatoglyphs. Histologically, they may also have atypical features. The most notorious and often striking feature is upward migration of melanocytes. This can mimic the pagetoid growth of melanoma in situ. Other features include overall symmetry, maturation with syringotropism, and lack of mitotic activity or significant cytologic atypia [J Cutan Pathol 2008;35:889-898].
Related Images: All related Images  acral_nevus_3_090401  acral_nevus_2_090401 

DermAtlas: Histology - nevus, acral
© 2001-2009, DermAtlas
Image Name: acral_nevus_2_090401   File Type: jpg
Diagnosis: NEVUS, ACRAL /
NEVUS, PIGMENTED /
NEVUS, PIGMENTED, ATYPICAL
  Category: neoplasm, melanocytic /
neoplasm, benign
Body Site: toe   Age: 33 years
Contributor: Greg Hosler, MD, PhD    
Description: There are large expansile nevocellular nests. There is syringotropsim of the melanocytes. Significant cytologic atpyia is not appreciated.
Comments: This 33 year old woman presented with a pigmented papule on her 3rd toe. It was biopsied to rule out melanoma. Acral nevi are a subset of melanocytic nevocellular nevi, which can have atypical clinical and histologic findings, but are benign. Clinically, the lesions often have irregular but sharp borders, likely due to the presence of dermatoglyphs. Histologically, they may also have atypical features. The most notorious and often striking feature is upward migration of melanocytes. This can mimic the pagetoid growth of melanoma in situ. Other features include overall symmetry, maturation with syringotropism, and lack of mitotic activity or significant cytologic atypia [J Cutan Pathol 2008;35:889-898].
Related Images: All related Images  acral_nevus_3_090401  acral_nevus_1_090401 

DermAtlas: Histology - nevus, acral
© 2001-2009, DermAtlas
Image Name: acral_nevus_3_090401   File Type: jpg
Diagnosis: NEVUS, ACRAL /
NEVUS, PIGMENTED /
NEVUS, PIGMENTED, ATYPICAL
  Category: neoplasm, melanocytic /
neoplasm, benign
Body Site: toe   Age: 33 years
Contributor: Greg Hosler, MD, PhD    
Description: The melanocytes proliferate along the junction, with foci of lentiginous growth. There are large nests, positioned along the retia. In one focus, single cells and few aggregates ascend into the epidermis. These are not cytologically atypical.
Comments: This 33 year old woman presented with a pigmented papule on her 3rd toe. It was biopsied to rule out melanoma. Acral nevi are a subset of melanocytic nevocellular nevi, which can have atypical clinical and histologic findings, but are benign. Clinically, the lesions often have irregular but sharp borders, likely due to the presence of dermatoglyphs. Histologically, they may also have atypical features. The most notorious and often striking feature is upward migration of melanocytes. This can mimic the pagetoid growth of melanoma in situ. Other features include overall symmetry, maturation with syringotropism, and lack of mitotic activity or significant cytologic atypia [J Cutan Pathol 2008;35:889-898].
Related Images: All related Images  acral_nevus_2_090401  acral_nevus_1_090401 

                             
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Bernard A. Cohen, MD, Christoph U. Lehmann, MD

DermAtlas was last updated: Oct-28-2009
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