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Benign Melanocytic Lesions
Published in Ashfaq A Marghoob, Ralph Braun, Natalia Jaimes, Atlas of Dermoscopy, 2023
Konstantinos Liopyris, Cristian Navarrete-Dechent, Silvia E. Mancebo, Michael A. Marchetti
The homogeneous pattern of nevi can be tan to light brown, pink, or blue in color (Figures 7b.22-7b.24). It is characterized by a paucity or total lack of discernible structures. A homogeneous blue pattern corresponds to a blue nevus. A homogeneous tan, light brown, or pink pattern is most frequently encountered in fair-skinned individuals. These nevi can be a diagnostic challenge because they may simulate Spitz nevi or hypomelanocytic/amelanotic melanoma by revealing vascular blush/erythema, dotted vessels either alone or in combination with comma, linear, or serpentine vessels, or nonspecific shades of structureless brown pigmentation. Evaluation of these lesions must always be performed in the context of the individual. For example, a solitary homogeneous pink lesion in a darker-skinned individual should be viewed with caution, whereas the presence of numerous homogeneous pink lesions with polymorphous vessels in a red-haired patient may be a normal finding. This concept is based on the observation that most individuals have nevi that resemble each other (i.e., moles breed true or signature nevus) (5) and allows the identification of morphologically outlier lesions (i.e., ugly duckling sign) (8).
Nevi
Published in Aimilios Lallas, Zoe Apalla, Elizabeth Lazaridou, Dimitrios Ioannides, Theodosia Gkentsidi, Christina Fotiadou, Theocharis-Nektarios Kirtsios, Eirini Kyrmanidou, Konstantinos Lallas, Chryssoula Papageorgiou, Dermatoscopy A–Z, 2019
Aimilios Lallas, Zoe Apalla, Elizabeth Lazaridou, Dimitrios Ioannides, Theodosia Gkentsidi, Christina Fotiadou, Theocharis-Nektarios Kirtsios, Eirini Kyrmanidou, Konstantinos Lallas, Chryssoula Papageorgiou
Combined nevi are traditionally described within the spectrum of blue nevi because they almost always consist of a blue nevus and an overlying common (usually junctional) nevus. Expectedly, dermatoscopy will reveal both components: a blue structureless area and a pigment network, corresponding to the blue and junctional nevus, respectively (Figure 2.56). The blue area might be located in the center of the reticular lesion or eccentrically.
Animal-type melanoma
Published in Longo Caterina, Diagnosing the Less Common Skin Tumors, 2019
ATM is a controversial entity since some authors regard it as an entity in its own right, whereas others prefer to include it in the category of pigmented epithelioid melanocytoma (PEM) to reflect its apparent similarity to blue nevus as seen in Carney complex. It also shows considerable overlap with some examples of malignant blue nevus.3,4
Primary orbital melanoma: A report of a case and comprehensive review of the literature
Published in Orbit, 2021
Modupe O. Adetunji, Brendan McGeehan, Vivian Lee, Maureen G. Maguire, César A. Briceño
The most common presenting symptoms and signs were unilateral proptosis (73%), decreased visual acuity (32%), periorbital pain (14%), diplopia (15%), and palpable mass (9%), but also included ptosis, eyelid swelling, visual disturbances, relative afferent pupillary defect, and poliosis. Imaging (CT or MRI) typically showed a well-circumscribed enhancing lesion, frequently resembling a benign tumor or arteriovenous malformation. A histologic diagnosis was performed in all cases via surgical biopsy or excision. Most tumors consisted of a variable mixture of spindled and epithelioid melanoma cells with some degree of pigmentation that were positive for melanocytic markers HMB-45, S-100, and Melan-A. Orbital blue nevus, a benign melanocytic precursor lesion, was present histologically in 42% of cases.
Diagnosis of the origin of an epibulbar melanocytic tumor with molecular genomics
Published in Ophthalmic Genetics, 2022
Ana Gonzalez-H.Leon, Yael Chavez, Zaid Saeed Kamil, Danny Ghazarian, Hatem Krema
Blue nevus (BN) are a heterogeneous group of tumors that arise in the dermis from spindle and dendritic melanocytes (6). Conjunctival blue nevi are relatively rare, representing only 0.6% to 3% of ocular surface melanocytic lesions and are generally considered to be benign (4). Melanomas that arise in the setting of blue nevi, also known as “malignant blue nevus” or melanoma ex blue nevus (MBN), share a similar histopathological and mutational profile with uveal melanoma (6). Distinguishing melanomas arising from a blue nevus from other conjunctival melanoma or metastatic melanoma may be challenging on histological grounds and often requires the use of ancillary molecular testing (6).
Noninvasive imaging for the diagnosis of melanocytic conjunctival tumor
Published in Expert Review of Ophthalmology, 2020
Elisa Cinotti, Marco Campoli, Damien Grivet, Jean Luc Perrot, Pietro Rubegni
In a small case series of 25 nevi (14 nevi of the substantia propria, 10 compound nevi, and 1 blue nevus), a globular and/or a homogeneous structureless pattern with color ranging from light brown to dark brown/black and regular border were found at dermoscopy, in all nevi of the substantia propria and 8 out of 10 compound nevi [17]. The blue-gray veil was identified in 4 out of 14 of the nevi of the substantia propria and in all compound nevi [17]. Two compound nevi showed a reticular pattern, satellitosis, and feeder vessels. Blue nevus showed a homogeneous pattern, a dark brown color, a bluish/gray veil and satellitosis [17]. In our opinion ‘satellitosis’ is an improper term because in dermatology this term is used to indicate metastatic melanoma in the skin around to the primary tumor and the nevi described as having satellitosis were unique lesions with irregular pigmentation and shape and did not show separated lesions in proximity that could be defined as ‘satellitosis’. The same for the reticular pattern that has been identified in some nevi of this series: reticular pattern seems more an irregular pseudonetwork formed by confluent globules than a real network as it is considered in skin dermoscopy. Moreover, to recognize details such as globules in a dermoscopic image of a conjunctival lesion taken with contact dermoscopes, it is necessary to have good contact between the tip of the dermoscope and the conjunctiva (Figure 2(b,c)). Considering feeder vessels, in our opinion, they are all present in elevated lesions and irritated conjunctiva and their specificity is therefore difficult to be established. Notably, in our experience, intralesional vessels with a different aspect from those feeding the lesions at the periphery were never observed in nevi.