Résumé
A 3-year-old boy presented with bluish patch and scattered blue spots on the left side of his face. After several sessions of laser treatment, the azury patch in the periorbital area became even darker. Histopathology showed many bipolar, pigment-laden dendritic cells scattered in the papillary and upper reticular dermis. Immunohistochemically, these cells were positive for S100, SOX-10, melan-A, P16, and HMB-45. The positive rate of Ki-67 was less than 5%. Finally, the lesion was diagnosed with nevus of Ota concurrent with common blue nevus. Therefore, for cases of the nevus of Ota with poor response to laser treatment, the possible coexisting diseases should be suspected.
Sujets)
Mâle , Humains , Enfant d'âge préscolaire , Naevus bleu/anatomopathologie , Naevus de Ota/thérapie , Peau/anatomopathologie , Face , Tumeurs cutanées/anatomopathologieRésumé
Case Description We report two cases of oral Blue Nevus. The first case is a 32 years old female patient with a brown-blue lesion on hard palate, with no clinical symptoms that has always been present but that recently had been growing. The second case is a 36 years old male patient with a brown macule on hard palate. Clinical Findings On case report 1, oral examinations revealed an irregular brown-blue macule, measuring 13 x 6 mm on hard palate. On case report 2, oral examination showed an oval brownish macule also located on hard palate. Treatment and Outcome: Excisional biopsy was performed in both cases and histopathology analyses revealed diagnosis of Blue Nevus. ClinicalRelevance: Diagnosis of pigmented lesions of the oral cavity can be challenging once there are avariety of causes such as racial pigmentation, systemic diseases, use of medication, metal tattooing, melanocytic nevus, melanoacanthoma, and melanoma. The correct diagnosis of this type of lesion is important to help professionals offer the best care for the patients and highlighting clinic criteria to differentiate malignant pigmented lesions is fundamental.
Relato de Caso: Relatamos doiscasos de Blue Nevus oral. O primeiro caso é de uma paciente de 32 anos, do sexo feminino, com lesão marrom-azulada em palato duro, sem sintomas clínicos que sempre estiveram presentes, mas que vinham crescendo recentemente. O segundo caso é de um pacientedo sexo masculino, 36 anos, com mácula marrom no palato duro.Achados clínicos: No relato de caso 1, os exames orais revelaram uma mácula marrom-azulada irregular, medindo 13 x 6 mm no palato duro. No caso clínico 2, o exame bucal mostrou uma mácula oval acastanhada também localizada no palato duro.Tratamento e Resultado: A biópsia excisional foi realizada em ambos os casos e a análise histopatológica revelou o diagnóstico de Nevo Azul.Relevância clínica: O diagnóstico de lesões pigmentadas da cavidade oral pode ser desafiador, uma vez que há uma variedade de causas, como pigmentação racial, doenças sistêmicas, uso de medicamentos, tatuagem em metal, nevo melanocítico, melanoacantoma e melanoma. O correto diagnóstico desse tipo de lesão é importante para auxiliar o profissional a oferecer o melhor atendimento aos pacientes e destacar critérios clínicos para diferenciar lesões malignas pigmentadas é fundamental.
Résumé
Introducción: La precisión diagnóstica de los nevus pigmentados ha sido una constante preocupación por los dermatólogos. Objetivo: Identificar la utilidad del dermatoscopio en la correlación de las características clínicas y los patrones dermatoscópicos de nevus pigmentados y su asociación con el diagnóstico histológico. Métodos: Se realizó una investigación observacional, analítica, de tipo correlacional, con pacientes de la zona sur de Ciego de Ávila que acudieron a la consulta de dermatología del Hospital Provincial General Docente Dr. Antonio Luaces Iraola en el periodo de abril 2017 a diciembre 2019. Resultados: Predominó el sexo femenino, el grupo de edad de 21 a 30 años, el fototipo II de piel y la zona expuesta (cara y V del escote) (18 ;35,3 por ciento) sin relación entre estas variables. El diagnóstico histológico de nevus de la unión se encontró asociado a la simetría (p < 0,004), la pigmentación homogénea (p < 0,000), así como al patrón dermatoscópico reticular (p < 0,000), globular (p < 0,002) y homogéneo (p < 0,008). El nevus intradérmico se observó asociado a la característica clínica de pigmentación homogénea (p < 0,007), y al patrón dermatoscópico reticular (p < 0,000) y homogéneo (p < 0,005). El nevus compuesto no presentó relación con las características clínicas ni dermatoscópicas. El nevus azul solo se correlacionó con el patrón dermatoscópico homogéneo (p < 0,025). Conclusión: Los patrones dermatoscópicos fueron útiles para el diagnóstico clínico e histológico de los nevus pigmentados(AU)
Introduction: The diagnostic precision of pigmented nevi has been a constant concern of dermatologists. Objective: To determine the usefulness of the Dermatoscope in the correlation of the clinical characteristics and the dermoscopic patterns of pigmented nevi and their association with the histological diagnosis. Methods: An analytical observational investigation of a correlational type was carried out in patients from the southern area of Ciego de Ávila who attended the Dermatology consultation at the Antonio Luaces Iraola Provincial Hospital in the period from April 2017 to December 2019. Results: The female sex, the age group of 21 to 30 years, skin phototype II and the exposed area (face and V of the neckline) (18; 35.3 percent) predominated with no relationship between these variables. The histological diagnosis of junctional nevus was found associated with symmetry (p <0.004), homogeneous pigmentation (p <0.000), as well as the reticular dermoscopic pattern (p <0.000), globular (p <0.002) and homogeneous (p <0.008). The intradermal nevus was observed associated with the clinical characteristic of homogeneous pigmentation (p <0.007), and with the reticular (p <0.000) and homogeneous (p <0.005) dermoscopic pattern. The composite nevus was not related to clinical or dermoscopic characteristics. The blue nevus only correlated with the homogeneous dermoscopic pattern (p <0.025). Conclusions: The dermoscopic patterns were useful for the clinical and histological diagnosis of pigmented nevi(AU)
Sujets)
Humains , Pigmentation , Diagnostic Clinique , Dermatologie , Naevus pigmentaire , Dermoscopie/méthodesRésumé
Los nevi azules son proliferaciones melanocíticas dendríticas benignas a nivel dérmico, congénitos o adquiridos, debido a un defecto migratorio embrionario de melanocitos a partir de la cresta neural. Se manifiestan clásicamente como una pápula, nódulo o placa de color azul o azul-gris. Muchos subtipos histológicos se han descrito, siendo los más comunes el nevus azul común, nevus azul celular y nevus azul combinado. Las formas esporádicas incluyen al nevus azul lineal, eruptivo, agminado y con satelitosis. La dermatoscopía característica muestra un patrón de pigmentación homogéneo monocromático azul o azul-grisáceo, con ausencia de otras estructuras. Sin embargo, se han descrito también patrones de pigmentación dicromáticos y multicromáticos, además de estructuras tales como red de pigmento, puntos, glóbulos, proyecciones radiadas, pseudópodos, áreas cicatriciales blanquecinas, patrón vascular y rosetas. El diagnóstico diferencial de los nevi azules incluye lesiones melanocíticas y no melanocíticas, benignas y malignas, destacando entre ellas el melanoma. Se presenta el caso de un paciente de sexo masculino de 30 años, portador de un nevus azul celular con cambios de rápida evolución, con desarrollo de lesiones satélites y un aspecto dermatoscópico sugerente de malignidad, simulando un melanoma.
Blue nevi are benign, congenital, or acquired, dermal dendritic melanocytic proliferations due to an embryonic migratory defect of melanocytes starting from the neural crest. They classically manifest as a blue or blue-gray papule, nodule, or plaque. Many histological subtypes have been described, including common blue nevus, cellular blue nevus and combined blue nevus. Sporadic forms include linear blue nevus, eruptive, agminate and with satellitosis. Characteristic dermoscopy shows a homogeneous monochromatic blue or steel-blue pigmentation pattern, with the absence of other structures. However, dichromatic and multichromatic pigmentation patterns have also been described, in addition to structures such as pigment network, dots, globules, streaks, pseudopods, whitish scar areas, vascular pattern and rosettes. Differential diagnosis of blue nevi includes melanocytic and non-melanocytic, benign and malignant lesions, most notably melanoma. The case of a 30-year-old male patient is presented, with a cellular blue nevus with rapidly evolving changes, with development of satellite lesions and a dermoscopic appearance suggestive of malignancy, mimicking melanoma.
Sujets)
Humains , Mâle , Adulte , Tumeurs cutanées/diagnostic , Naevus bleu/diagnostic , Tumeurs cutanées/anatomopathologie , Naevus à cellules épithelioïdes et fusiformes , Naevus bleu/anatomopathologie , Dermoscopie , Diagnostic différentiel , Mélanome/diagnosticRésumé
Localized cutaneous argyria is a rare condition in which the skin changes into blue-grey spots due to the absorption of silver. The lesions need to be differentiated from other pigmentary disorders and require radiographic and histological examination for more accurate diagnosis. Scanning electron microscopy and energy dispersive x-ray spectroscopy can be a confirmatory tool in the evaluation of silver elements in biopsy tissue. This report shows the localized cutaneous argyria in earlobe of a 21-year-old woman who wears silver earrings for 10 years.
Sujets)
Femelle , Humains , Jeune adulte , Absorption , Argyrie , Biopsie , Diagnostic , Oreille , Microscopie électronique à balayage , Naevus bleu , Argent , Peau , Spectrométrie d'émission XRésumé
Primary or metastatic malignant melanoma can mimic benign blue nevus in rare cases, making the diagnosis challenging. Herein, we report an exceptionally rare case of blue nevus-like melanoma and its blue nevus-like metastasis which was detected by catheterized urine cytology. The patient presented with blue-colored papuloplaques on his temple which were diagnosed as blue nevus-like melanoma on punch biopsies. While he was admitted for administration of chemotherapy, hematuria was detected. Catheterized urine cytology revealed singly scattered oval to spindle-shaped pigmented cells with a moderate degree of variation in shape and size. Many of them had small nuclei with indiscernible to inconspicuous nucleoli while only a few cells showed nuclear enlargement and nuclear hyperchromasia, which could be diagnostic pitfalls. Most of the cells on the smear were positive for HMB45 immunostaining, which confirmed the diagnosis of metastatic blue nevus-like melanoma. To the best of our knowledge, the present case is the first report describing cytomorphologic findings of blue nevus-like metastasis of melanoma in the urine specimen.
Sujets)
Humains , Biopsie , Cathéters , Diagnostic , Traitement médicamenteux , Hématurie , Mélanome , Métastase tumorale , Naevus bleuRésumé
Abstract: Melanomas can arise either de novo (70%) or from pre-existing melanocytic lesions (30%). Of the latter, most cases arise at the dermoepidermal junction from small congenital or acquired non-blue nevi while only a few arise from blue nevi, notably the cellular subtype and less commonly the common (dendritic) type. Melanomas that arise from blue nevi usually occur on the scalp with greater frequency, as in the case described. Although previous studies have discussed melanoma arising from giant congenital blue nevi, few have discussed those arising from intermediate blue nevi. We present a case of a 52-yearold man with melanoma on the scalp evolving from an intermediate congenital common blue nevus.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Cuir chevelu/anatomopathologie , Tumeurs cutanées/congénital , Naevus bleu/congénital , Naevus bleu/anatomopathologie , Tumeurs de la tête et du cou/anatomopathologie , Mélanome/anatomopathologie , Biopsie , Issue fatale , Derme/anatomopathologieRésumé
No abstract available.
Sujets)
Femelle , Humains , Asiatiques , Complexe de Carney , Naevus bleuRésumé
Blue nevi can present clinically as blue, gray, brown, or black solitary nodules or plaques on the skin. Histologically, they represent collections of melanocytes and melanophages in the dermis. We presented here a case of a cellular blue nevus in a 20 years old man that presented as an enlarging blue-gray nodule on the right buttock. These cases can be challenging both clinically and histologically because malignant melanoma or malignant transformation of a blue nevus could be considered.
Résumé
Epithelioid blue nevus is a rare variant of blue nevus that has been recently described in patients with the Carney complex. However, sporadic cases have been reported even without the Carney complex. It typically presents as an asymptomatic, blue-gray, smooth-surfaced macule or papule occurring most often on the extremities and trunk. However, a few cases occurring on the mucosa have been reported. A 21-year-old man presented with a 0.4-cm sized solitary dark brownish or black papule on the lower lip. On histological examination, the major part of the specimen showed an infiltration of intensely pigmented epithelioid cells, the rest was composed of mildly pigmented spindle cells. There was no junctional activity, necrosis, or cellular atypia. These findings were consistent with epithelioid blue nevus. The patient did not exhibit any features associated with the Carney complex. No evidence of recurrence was observed during the follow-up period of 24 months. Herein, we report a rare case of epithelioid blue nevus arising on an unusual site.
Sujets)
Humains , Jeune adulte , Complexe de Carney , Cellules épithélioïdes , Membres , Études de suivi , Lèvre , Muqueuse , Nécrose , Naevus bleu , RécidiveRésumé
Epithelioid blue nevus is a rare variant of blue nevus that was first described in patients with Carney complex, a familial lentiginosis and multiorgan neoplasm (spotty cutaneous pigmentation, cutaneous/cardiac/mammary myxomas, endocrine overactivity, and psammomatous melanotic schwannomas). Epithelioid blue nevus is an intradermal melanocytic nevus composed of heavily pigmented globular and polygonal cells and lightly pigmented spindle and dendritic cells. Recently, cases of epithelioid blue nevi have been reported in patients without Carney complex. Herein, we describe a child who developed epithelioid blue nevus on her right foot without Carney complex symptoms and review the relevant literature.
Sujets)
Enfant , Humains , Complexe de Carney , Cellules dendritiques , Pied , Lentigo , Myxome , Naevus bleu , Naevus pigmentaire , PigmentationRésumé
Blue nevus is a neoplasm composed of pigmented dendritic dermal melanocytic cells in the reticular dermis. The lesion clinically presents as a well dermacated cerulean-blue or bluish black colored papule or plaque that usually measure less than 1 cm in diameter. Pilar sheath acanthoma is a rare, benign follicular hamartoma commonly affecting middle-aged and elderly individuals. It is characterized by a small, solitary, skin colored papule situated on the head and neck, particularly around the upper lip. We report a rare case of a blue nevus associated with a pilar sheath acanthoma in a 26 year-old man presented with a bluish papule on the neck.
Sujets)
Sujet âgé , Humains , Acanthome , Derme , Hamartomes , Tête , Lèvre , Cou , Naevus bleu , PeauRésumé
We experienced an unusual case of the cellular nevus on the dorsal surface of the second metacarpophalangeal joint. We performed a local excision followed by immunohistochemical analysis. Cellular blue nevus should be considered in the differential diagnosis when a characteristic blue-black mass is found in the finger. Accurate diagnosis based on immunohistochemical analysis, appropriate surgical treatment and vigilant follow-up are mandatory to prevent any malignant transformation.
Sujets)
Diagnostic différentiel , Doigts , Études de suivi , Mélanome , Articulation métacarpophalangienne , Naevus , Naevus bleuRésumé
Blue nevi are characterized by a collection of pigment-producing melanocytes in the dermis. These lesions clinically present as well demarcated cerulean-blue or bluish black colored papules or plaques that usually measure less than 1 cm in diameter. They are typically found on the dorsal surface of the hands and feet or in the head and neck region; however, they are rarely found in the oral cavity. These lesions are usually benign and stable over time. However, malignant melanomas developing in or associated with a blue nevus (which is also called malignant blue nevus) have been only rarely reported. A malignant blue nevus might develop in a common blue or cellular blue nevus, a giant congenital nevus or in a nevus of Ota, or it may be malignant from the start. Malignant blue nevi most commonly are found on the scalp. A malignant blue nevus of the lip has not been previously reported in the medical literature. We report here on a patient with a malignant melanoma associated with a blue nevus of the lip. The malignant melanoma was presumed to have developed from a blue nevus that was present on the upper lip of a 50-year-old male.