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Congential Nevus Mimicking Melanoma in Infancy
Author(s) -
Keehan P.,
Rye B.,
Cockerell C.
Publication year - 2005
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.0303-6987.2005.320dn.x
Subject(s) - pagetoid , melanoma , dermis , nevus , lesion , pathology , medicine , dermatology , biopsy , papillary dermis , reticular dermis , hyperpigmentation , epidermis (zoology) , anatomy , immunohistochemistry , cancer research
A five‐month old girl presented with a 5 cm brown patch on her right lower leg. The lesion had a 6 mm area of hyperpigmentation that was removed by shave biopsy for pathologic diagnosis. The clinical diagnosis at the time was that of congenital nevus but the multicolored appearance of the lesion raised the index of suspicion for melanoma. Histology revealed junctional activity with melanocytes distributed in the dermis including migration around appendages and among collagen bundles as seen in congenital nevi. However, there were some unusual features that warranted careful analysis. The lesion was asymmetric, with numerous single melanocytes in confluence at the dermo‐epidermal interface. Single cells and nests were noted in the epidermis. Our case illustrates a congenital nevus with atypical patterns easily confused with those of melanoma. Our lesion exhibited pagetoid melanocytes, which is considered virtually diagnostic of melanoma. However, these melanocytes were monomorphous as opposed to the pleomorphic appearance found in melanoma. Additionally, there was evidence of cellular maturation in the dermis as well as a lack of variance in nest size, which favors the diagnosis of congenital nevus1.