Acral Pigmented Spitz Nevus That Clinically Mimicked Acral Lentiginous Malignant Melanoma

Abstract

Fig. 1. A dark brown-to black-colored, indurated macule with irregular pigmentation on the dorsum of the left fifth toe (inset: dermoscopic image).

Comparative Analysis of PRAME Expression in 127 Acral and Nail Melanocytic Lesions

“…The differential diagnosis between benign and malignant melanocytic lesions in acral sites is traditionally hampered by the peculiar histologic features of acral skin. Atypical characteristics such as pagetoid spread of melanocytes in suprabasal layers, lentiginous melanocytic growth admixed with junctional nests, irregular displacement of junctional nests, scattered cytologic atypia, and traumatism are in fact frequently encountered in benign nevi, raising the risk of overdiagnosis of melanoma 1–3…”

Acral pigmented Spitz nevus in a child with transepidermal migration of melanocytes: Dermoscopic and reflectance confocal microscopic features

“…Growth of a pigmented lesion that is symmetric and not nodular is more indicative of a Spitz nevus, whereas asymmetry and nodular growth are more indicative of ALM, but it is often difficult to assess these features clinically. For example, a changing nevus on the foot of a 4‐year‐old boy grew and had variegated pigmentation, with initial concern for malignancy . The lesion was ultimately excised and determined to be a benign pigmented acral Spitz nevus.…”

“…For example, a changing nevus on the foot of a 4-year-old boy grew and had variegated pigmentation, with initial concern for malignancy. 5 The lesion was ultimately excised and determined to be a benign pigmented acral Spitz nevus. Acral nevi may also demonstrate transepidermal elimination of melanocytes, as noted in the case of a 10-…”

“…3,4 The acral presentation of pigmented Spitz nevi is rarely described in the literature. 5 Dermoscopy has proven to be of significant utility as a diagnostic tool in the evaluation of these lesions. [5][6][7] Reflectance confocal microscopy (RCM) is a noninvasive imaging modality with a maximum imaging depth of up to 200 lm.…”

“…5 Dermoscopy has proven to be of significant utility as a diagnostic tool in the evaluation of these lesions. [5][6][7] Reflectance confocal microscopy (RCM) is a noninvasive imaging modality with a maximum imaging depth of up to 200 lm. It has been found to aid in the diagnosis of clinically equivocal lesions, including differentiation of acral lentiginous melanoma (ALM) from acral nevi, 8 but skin lesions on the palms and soles are rarely investigated using RCM because of the thickness of the stratum corneum, which makes visualization of deeper structures difficult.…”