Dermoscopic features of acral melanocytic nevi in a case series from Mexico

Abstract: Background: Pigmented lesions on acral sites are common; clinical differentiation of nevi and early melanoma can be challenging. In these cases, dermoscopy can provide a more accurate diagnosis. Most dermoscopic patterns on acral skin have been described in Asian and European populations, while there are few studies in Latin American populations. Objectives: To determine the frequency of pigmented lesions in volar skin and their dermoscopic patterns in a Mexican population. Methods: An observational, descriptive, cross-sectional study was performed in Hispanic patients with the presence of at least one pigmented lesion on acral skin. Clinical and dermoscopic images were obtained. These were subsequently evaluated independently by two dermatologists trained and experienced in dermoscopy. Results: A total of 582 pigmented lesions on volar skin were diagnosed in 321 patients. Overall, prevalence of acral pigmented lesions on volar skin was 6.8%. For both observers, parallel furrows were the most frequent pattern described, but for observer 2, a lattice-like pattern was prevalent on the toes and a homogeneous pattern on the sides of the feet. There was lower inter-observer agreement, with a kappa index of 0.144. Study limitations: The lesions were not biopsied, so clinical-histological correlation could not be performed. The study did not correlate dermoscopic patterns with age. Conclusions. As previously reported by other authors, parallel furrows were the most frequently found dermoscopic pattern on palmoplantar skin.

A case of collision tumor or transdifferentiation between malignant melanoma and leiomyosarcoma.

A 73-year-old woman was referred to the hospital due to a pigmented, asymptomatic nevus on her right arm that had changed in size and color. The histopathological examination showed a superficial spreading malignant melanoma, Clark level III, 2.26 mm in thickness. Two years later, the patient presented a 10 cm rapidly growing mass in her right axilla. The mass in the axilla measured 12.5 ΄ 9 ΄ cm. It revealed a lymph node metastases with a tumor growth composed of two different contiguous morphological and immunohistochemical components, respectively, melanosomes and leiomyosarcoma. The combination of a melanocytic nevus with other tumor of epidermal or adnexal origin has been described before, but still the co-existence of two different neoplasms within a lesion is still uncommon. The most common combination is basal cell carcinoma and melanocytic nevus or one of them together with a seborrheic keratosis. There have also been occasional reports of rhabdomyosarcomatous differentiation. However, mesenchymal differentiation, and in this case leiomysarcoma, with formation of heterologous elements in melanocytic tumor is very rare. Another plausible explanation may be that malignant melanoma cells could have transdifferentiated into a leiomyosarcomatoid phenotype with resulting metastases of either type. Malignant melanomas have shown a wide variety of cytological changes and can mimic carcinomas, lymphomas, and sarcomas. Spindle cell melanomas commonly simulate spindle cell carcinomas. It has also been documented that desmoplastic melanomas can change into fibroblastic, Schwannian, and myofibroblastic differentiation.

Survey of skin disorders in newborns: clinical observation in an Egyptian medical centre nursery

The frequency of neonatal skin disorders has not been well studied in Egypt. Our aim was to address patterns of dermatologicaf changes in a sample of Egyptian newborns. In a descriptive prospective cohort study 600 newborns in Sohag University hospital nursery were dermatologically examined within the first 5 days of birth. Skin disorders were detected in 240 neonates [40.0%]. Birthmarks were found in 100 neonates [16.7%], mainly melanocytic type [mongolian spots in 11.7% and congenital melanocytic naevi in 2.7%]. Fungal skin infections, including oral moniliasis, fungal infection in the napkin area or candidal intertrigo, were detected in 13.3% and bacterial infections in 1.3% of neonates. Comparisons with other studies worldwide indicated a higher rate of fungal infections and lower rate of birthmarks in our study. Routine neonatal dermatological evaluation is recommended, especially in view of the high rate of fungal skin infections

Análisis de la densidad y distribución anatómica de nevos melanocíticos adquiridos, en adolescentes del estrato socioeconómico bajo de Santiago de Chile / Body distribution and density of acquired melanocytic nevi in adolescents of low socioeconomic stratus of Santiago, Chile

Background: There is an increase in the incidence of malignant melanoma in Chile. Previous studies have shown that the density and size of acquired melanocytic nevi (AMN) are a risk factor for developing malignant melanoma. Aim: To assess the number and anatomical distribution of acquired melanocytic nevi in Chilean adolescents. Material and methods: The number of AMN was counted in 30 anatomical sites in 201 Chilean school children (111 females), aged from 11 to 15 years. The number oí small AMN (2-4.9 mm) and large AMN (>5 mm ofdiameter) was determined. Results: Mean AMN number per person was 32.7 (95 percent confidence interval (CI) 30.7-42.3) in males and 29 (95 percent CI 271-38.6) in females (p =NS). Males had a higher number of AMN in the face, neck and trunk. Females had a higher number of AMN in the upper and lower limbs. Older children, adolescents with history of sunburns and with lighter skin had a higher number of total, small and large nevi. Conclusions: The average number ofAMNfound in this study is similar to that reported in the literature. The differences in site distribution between males and femalesmay be explainedby a differentsun exposurepattern.

Nevos melanocitos congénitos / Congenital melanocytic nevi

Los nevos melanocítos congénitos (NMC) constituyen un importante grupo de lesiones pigmentarias en los niños por su elevada prevalencia y por el compromiso funcional y estético que producen. Según su tamaño, pueden clasificarse en pequeños, medianos y gigantes. Éstos últimos, los menos frecuentes, en un alto porcentaje se asocian a melanosis neurocutánea, cuadro de mal pronóstico neurológico y vital.Los NMC gigantes, y recientemente los pequeños, se consideran lesiones precursoras de melanoma maligno cutáneo, por lo tanto, el tratamiento de elección es la resección completa. El riesgo de transformación maligna de los NMC medianos aún se desconoce.

Evaluación de tumores cutáneos en la infancia / Evaluation of cutaneous tumors in infancy

Se analizó un estudio retrospectivo de las lesiones tumorales en la infancia durante un período de cinco años (1994-1998) en el Servicio de Dermatología del Hospital Humberto Notti de Mendoza, Argentina. El 99 por ciento de la patología tumoral correspondió a tumores benignos, y los nevus melanocíticos fueron los de mayor frecuencia

Lesiones cutáneas en recién nacidos / Skin injuries in neonates

Las lesiones cutáneas en recién nacidos son frecuentes. La mayoría son banales y transitorias; sin embargo, algunas requieren seguimiento o son marcadores de otras enfermedades importantes. El objetivo de este trabajo fue determinar la frecuencia de presentación y algunas características de diferentes lesiones cutáneas en un grupo de 1.203 recién nacidos de hasta 72 horas de vida. De ellos, 91,2 por ciento presentó alguna lesión cutánea clasificada según criterios clínicos como pigmentada, vascular y otros. Los resultados mostraron mancha mongólica en 45 por ciento, nevos pigmentados en 2 por ciento y manchas café con leche en 2 por ciento. La lesión vascular más frecuente fue la mancha salmón (44 por ciento). Otras lesiones cutáneas frecuentes fueron eritema tóxico (42 por ciento) e hiperplasia de glándulas sebáceas (32 por ciento). El reconocimiento adecuado de lesiones cutáneas al momento del nacimiento es muy importante para definir pronóstico y evolución

Incidencia de lesiones cutáneas en el recién nacido / Incidence of cutaneous injuries in the newborn

En el recipen nacido se puede apreciar una gran variedad de lesiones cutáneas, que generalmente corresponden a cambios fisiológicos de la piel, transitorios y benignos. Sin embargo, se pueden presentar lesiones cutáneas marcadoras de enfermedades sistémicas, tumorales u otras enfermedades dermatológicas que tanto pediatras como dermatológos deben saber diferenciar. El objetivo de nuestro trabajo fue conocer la incidencia y frecuencia relativa de estos cambios cutáneos