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Desmoplastic nevus
Published in Longo Caterina, Diagnosing the Less Common Skin Tumors, 2019
In 1980, Barr et al. described desmoplastic nevus as a distinct histologic entity, different from the Spitz nevus and not a manifestation of age-related changes as previously considered.1 Desmoplastic (sclerotic) nevus is an infrequent, poorly characterized, benign melanocytic proliferation, with only a few case series published to date. Clinically, it usually presents as an asymptomatic, small (ranging between a few millimeters and 1 or 2 cm), flesh-colored, erythematous or slightly pigmented firm papule or nodule (Figures 8.1 through 8.3) that may be confused with other fibrous entities and atypical melanocytic proliferations including melanoma. It often occurs on the extremities of young adults (average age 30 years), with a female predominance. Histopathologically, it is characterized by spindle-shaped or epithelioid melanocytes, with readily appreciable pseudonucleoli embedded within a fibrotic stroma. It is included in the spectrum of dermal proliferations with a desmoplastic component composed by dermatofibroma, sclerotic blue nevus, desmoplastic nevus and desmoplastic melanoma. Their differentiation can sometimes represent a diagnostic dilemma for both clinicians and histopathologists.2–4 In most of the cases, they are removed because of a history of changes and because of their unusual dermatoscopic features. The main differential diagnosis is with desmoplastic melanoma, which is more frequently seen in older patients on sun-exposed areas.5–6
Melanoma-associated emergencies
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Vidya Kharkar, M. R. L. Sujata
Desmoplastic melanoma is a rare but histologically and clinically distinct variant of melanoma [39]. It presents as a slowly growing plaque, nodule, or scar-like growth, and it is usually amelanotic and located in chronically sun-exposed areas of older patients. It may clinically simulate a scar, or nonmelanoma skin cancer (e.g., basal cell or squamous cell carcinoma).
Melanocytic Neoplasms
Published in Omar P. Sangueza, Sara Moradi Tuchayi, Parisa Mansoori, Saleha A. Aldawsari, Amir Al-Dabagh, Amany A. Fathaddin, Steven R. Feldman, Dermatopathology Primer of Cutaneous Tumors, 2015
Desmoplastic melanoma: Proliferation of spindle cells with variable degree of atypia in the dermisPatchy infiltrates of lymphocytesIn some cases there is an epidermal component
Desmoplastic melanoma: a brief review and the efficacy of immunotherapy
Published in Expert Review of Anticancer Therapy, 2019
Cesar E. Ochoa, Richard W. Joseph
Desmoplastic melanoma is a relatively rare variant of melanoma with unique clinical and pathologic characteristics as well as genetic drivers. Unlike cutaneous melanoma, DM usually lack pigment and are characterized by dense spindle-shaped melanoma cells with abundant fibrous connective tissue. DM typically presents at a later stage and often times have a neurotropic pattern of spread likely influencing the high rate of local recurrence seen in this disease. While DM lacks actionable mutations, it often harbors a high mutational burden possibly due to the primary location of the head and neck and thus excess exposure to UV light induced DNA damage, providing the rationale behind the high response rate observed with immunotherapy.
Tertiary lymphoid structures in desmoplastic melanoma have increased lymphocyte density, lymphocyte proliferation, and immune cross talk with tumor when compared to non-desmoplastic melanomas
Published in OncoImmunology, 2023
Nicole L. Edmonds, Sarah E Gradecki, Priya Katyal, Kevin T Lynch, Anne M Stowman, Alejandro A Gru, Victor H Engelhard, Craig L Slingluff, Ileana S. Mauldin
With institutional IRB approval (IRB #19694), 11 cases of “pure” primary desmoplastic melanoma located on the skin or subcutaneous tissues that met inclusion criteria in our prior work3 were included in this study. Eight of these samples were determined, in our prior work to have classical TLS, defined by organized T-cell and B-cell regions in addition to PNAd+ vasculature.3