Case Of Congenital Melanocytic Nevus Research Articles

Congenital Melanocytic Nevus: An Unusual Presentation

The overgrowth of melanocytes produces congenital melanocytic nevus. They are commonly present since birth, and the common terms used to describe them are called 'bathing trunk,' 'coat-sleeve,' or 'stocking naevi,' and they are usually found over thighs and back. The giant congenital nevus of size larger than twenty centimeters is highly pigmented and usually hairy. It is more commonly found in females compared to males. It is well recognized that the lesion's displeasing nature might have psychological and social ramifications, negatively affecting the patient's self-esteem, particularly females. Although congenital melanocytic nevus is mostly clinically diagnosed, the histological investigation is required to confirm the diagnosis and rule out malignant changes. The likelihood of transforming the giant nevus to malignant melanoma accounts for approximately five percent; fifty percent of melanomas develop before age two, and eighty percent develop before age seven. The risk of transformation to malignant melanoma is early in giant melanocytic nevus cases and adolescence in small and medium-sized nevi cases. Other complications like transformation to neurocutaneous melanosis consisting of the spread of melanoma to the central nervous system and leptomeninges are also dreadful. Hence, early removal is recommended. Here, we have reported a rare case of a six-year-old patient with a medium-sized nevus on their face with hairy tufts in between. On biopsy, the diagnosis was made as a junctional nevus. After which, the patient was managed with subsequent lesion excision and split skin grafting with an uneventful postoperative period. Our case report aims to report a rare case of congenital melanocytic nevus and to determine the importance of timely diagnosis and intervention. Keywords: , , , ,

A case of congenital melanocytic nevus with Sutton’s phenomenon

A case of congenital melanocytic nevus with Sutton’s phenomenon

Seri Eksizyon Uygulanan Bir Konjenital Melanositik Nevüs Olgusu ve Diğer Tedavi Seçeneklerinin Gözden Geçirilmesi

Seri Eksizyon Uygulanan Bir Konjenital Melanositik Nevüs Olgusu ve Diğer Tedavi Seçeneklerinin Gözden Geçirilmesi

Proliferative nodules in congenital melanocytic nevi: a clinicopathological analysis of eight cases

To study the clinicopathologic features, differential diagnosis and prognosis of proliferative nodules(PNs) in congenital melanocytic nevi(CMN). Histopathologic evaluation and immunohistochemical study by EnVision method were carried out in 8 cases of PNs in CMN. The clinical information and follow-up data were analyzed. The age of patients ranged from 1 to 54 years (mean 27.6 years). Tumors were located on face (3 cases), on back (2 cases), upper extremities (2 cases) and lower extremities(1 case). Microscopically, PNs with expansile growth were observed in 8 cases of CMN. Melanocytes in PNs show variable pleomorphism with a mitotic activity of 0 to 4 per 10 high power fields. Blending of cells with adjacent CMN was noted in 6 cases. According to the morphology of melanocytes in PNs, it was classified into different types including large oval melanocytes (4 cases), small melanocytes (2 cases) and Spitz-nevus-like forms (2 cases). Immunohistochemically, melanocytes in PNs were consistent with those in adjacent CMN. They were diffusely positive for S-100 protein, but were either negative or focally positive for HMB45. Less than 5% of melanocytes were positive for Ki-67 in 8 cases of PN. Follow-up was available in all cases, ranging from 9 to 82 months. Seven patients with excision of single PN in CMN were alive with no evidence of disease, while 1 patient with multiple PNs in CMN was stable with disease after 62 months follow-up. PN is a rare melanocytic lesion arising in CMN. Recognition of its specific histologic features can help to avoid being misdiagnosed as melanoma. Long term follow-up should be recommended in patients with PNs, especially in those with atypical histologic features. Further investigation is needed to elucidate its clinical behavior.

Atrophic Congenital Melanocytic Nevus Mimicking Rapidly Involuting Congenital Hemangioma

Congenital melanocytic nevi (CMN) are benign skin lesions present in some newborns. We describe a newborn boy with a giant CMN on the scalp. It appeared as an atrophic patch with a central nodule that was suggestive of a rapidly involuting congenital hemangioma or some other vascular tumor. Histopathology confirmed the diagnosis of CMN. Magnetic resonance imaging was normal, excluding leptomeningeal melanocytosis. We did not find any other cases of CMN with this presentation in the literature.

Meyerson Phenomenon in Children: Observation in Five Cases of Congenital Melanocytic Nevi

To describe the characteristics of five pediatric patients with the Meyerson phenomenon associated with congenital melanocytic nevi, five cases were reviewed to retrieve information relating to clinical presentation, treatment and evolution of the eczematous phenomenon and of the nevi. Three of five patients were male. Mean age at presentation of the Meyerson phenomenon was 23 months (range: 4 mos-4 yrs). Three patients presented with only one halo eczematous lesion, while two patients presented with more then one halo eczematous lesions. The halo eczematous lesions were located on the leg, arm, and trunk in four, two, and two patients, respectively. All were associated with congenital melanocytic nevi with overlying hypertrichosis. Four were treated with topical corticosteroids, and five developed some degree of hypopigmentation within the nevic lesion. In children with Meyerson phenomenon associated with congenital hairy melanocytic nevi, neither trigger to the eczematous eruption nor preferential gender or anatomical site location was identified. The Meyerson phenomenon evolved towards hypopigmentation of the congenital melanocytic nevic lesions in all patients but no other cutaneous changes were observed on follow-up.

Congenital melanocytic nevi and nevus spilus have a tendency to follow the lines of Blaschko: An examination of 200 cases

There have been few reports about the characteristics of the pigmentary arrangement of congenital melanocytic nevi (CMN) and nevus spilus (NS). Though the lines of Blaschko, which don't correspond to other lines such as Langer's lines and skin dermatomes, are well known to be followed by some rare pigmentary disorders, the relationship between these two disorders and the lines of Blaschko has not been discussed. Therefore, through an examination of 200 cases, we investigated whether or not the arrangement of CMN and NS follow the lines of Blaschko. Thirty-nine out of 92 cases (42.4%) of CMN and 67 out of 108 cases (62.0%) of NS were considered to follow the lines of Blaschko. Today, the idea is widely accepted that two functionally different cells proliferate during early embryogenesis of the skin which is caused from mosaicism and, as a result, the lines of Blaschko appear visually. In our results, we found that there were some cases of CMN and NS which showed a relationship with the lines of Blaschko, which is meaningful considering that the lesions and the lines are both related to pigmentary gene anomalies. The result was compared with CMN and NS by the chi(2) test. NS showed a predominant tendency to follow the lines with a significant difference (P = 0.0055). This may indicate that the lines of Blaschko reflect more clearly the proliferation of the epidermal cells than other cells in growth of the skin of the embryo. Further studies are required to elucidate the reason why some cases follow these lines and others do not.

Genetic Changes in Neoplasms Arising in Congenital Melanocytic Nevi: Differences Between Nodular Proliferations and Melanomas

Large congenital melanocytic nevi (CMN) are at an increased risk of developing melanoma. Several forms of secondary proliferations can arise in congenital nevi on rare occasions. Although some of these closely resemble melanoma both clinically and histologically, metastasis is rare. We used comparative genomic hybridization to analyze chromosomal aberrations in different types of proliferations arising in CMN and compared them to typical congenital nevi, clear-cut melanomas arising in congenital nevi, as well as primary cutaneous melanomas that were not associated with a CMN. Cases of CMN and CMN with secondary proliferations were assigned to six groups according to the predominant histological pattern: group I, bland congenital nevi (n = 6); group II, congenital nevi with foci of increased cellularity (n = 4); group III, CMN with a proliferation simulating superficial spreading melanoma in situ (n = 3); group IV, CMN with a proliferation simulating nodular melanoma (n = 9); group V, proliferating neurocristic hamartoma (n = 1); and group VI, melanoma arising in congenital nevus (n = 6). No aberrations were found in groups I to III, whereas seven of nine cases of group IV, and one of one case of group V, showed aberrations. In group IV six of seven cases with aberrations (86%) showed numerical aberrations of whole chromosomes exclusively. This pattern differed significantly from the findings in melanoma that arose within CMN (n = 6), group VI, or independent of CMN (n = 122) in which only 5% showed numerical changes only. The single case in group V showed aberrations similar to melanoma. The finding of frequent numerical chromosomal aberrations in atypical nodular proliferations arising in CMN identifies these as clonal neoplasms with a genomic instability consistent with a mitotic spindle checkpoint defect. This difference compared to the aberration pattern found in melanoma might explain their more benign clinical behavior and may be of diagnostic value in ambiguous cases.