Abstract
Background -Deep penetrating nevus (DPN) is a distinct variant of melanocytic nevus and remains a histopathologic challenge to pathologists because of its resemblance to blue nevus, malignant melanoma, pigmented Spitz nevus, and congenital melanocytic nevus. It often goes unrecognized due to its relative rarity.Case presentation -Here we report a case of DPN of the left anterior leg in a 51-year old female. A brief review of the literature shows that these lesions have a distinct growth pattern and cellular morphology that can differentiate these lesions from other entities including malignant melanoma.Conclusion -It is important to recognize these features because DPN carries a better prognosis than malignant melanoma.
Highlights
Deep penetrating nevus is a distinct variant of melanocytic nevus
Due to its striking histologic similarities with other cutaneous pigmented lesions, it is often difficult to recognize as a separate entity and is misinterpreted as malignant melanoma [2]
We present a case of Deep penetrating nevus (DPN), describe its histopathologic and clinical features, and provide a brief review of the literature
Summary
Deep penetrating nevus is a distinct variant of melanocytic nevus. It is characterized by its dark pigmentation, occurring mostly on the face, neck, or shoulder, and usually measures less than 1 cm in diameter [1]. Punch biopsies were obtained from multiple tan-brown lesions on both legs These biopsies showed both typical and atypical melanocytic hyperplasia along with compound and dermal nevi. In February of 2005, she presented to us with a left lower leg skin lesion in the same area as the prior melanoma. The sections showed deep dermal and subcutaneous nested proliferations of spindle and epithelioid cells arranged in a wedge-shaped pattern with the base in parallel with the reticular dermis andthe apex oriented toward the epidermis (Fig. 1). These nests diffusely penetrated and infiltrated the surrounding tissues (Figure 2).
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