Dermoscopic Characteristics of Congenital Melanocytic Nevi Affecting Acral Volar Skin

Abstract

To characterize the dermoscopic features of acral congenital melanocytic nevi (CMN).Design: Retrospective independent evaluation of dermoscopic images by 2 dermoscopists.Setting: A dermatology clinic at a university hospital.

Clinical and dermoscopic characteristics of congenital melanocytic naevi

“…Little is known about CN on the volar skin, and our series of 38 acral nevi is one of the largest. According to the limited literature, the parallel furrow pattern is the commonest dermoscopic pattern observed on CN of the volar skin, consistent with our results. We found an increased number of CN with a lattice‐like pattern unlike Chuah et al We did not observe any CN with a parallel ridge pattern, a known pattern for melanoma, which is rare in CN of the volar skin .…”

“…According to the limited literature, the parallel furrow pattern is the commonest dermoscopic pattern observed on CN of the volar skin, consistent with our results. We found an increased number of CN with a lattice‐like pattern unlike Chuah et al We did not observe any CN with a parallel ridge pattern, a known pattern for melanoma, which is rare in CN of the volar skin . Lesions demonstrating an homogeneous component, as the two that we detected, have been described before; however, we did not find any CN presenting with a diffuse light background pigmentation, probably a feature in older ages.…”

Dermoscopic Characteristics of Acquired Melanocytic Naevus in Childhood Affecting the Acral Region

“…We reported previously that this pattern accounted for 37.5% of acral CMN, and others showed that it was present in 14% of acral AMN (4,5). It is notable that the "peas-in-a-pod" pattern is observed in early onset melanocytic naevus in the acral region, in both congenital and acquired types, which suggests that AMN with the "peas-in-a-pod" pattern shares the same characteristics with CMN.…”

Parallel ridge pattern on dermoscopy: observation in non-melanoma cases

“…7 We disagree with the specificity attributed to the parallel ridge pattern for the dermoscopic diagnosis of acral melanoma, because we have increasingly observed benign acral lesions, such as lentiginosis, racial melanosis, melanocytic nevi, drug-induced hyperpigmentation, subcorneal hemorrhage and dye-related pigmentation, particularly in higher phototypes, presenting this same pattern. However, we recognize that on lentiginous acral melanoma, the melanocytic proliferation is disseminated and occupies the crista profunda intermedia , determining not only the ridge pigmentation, but also the obliteration of the eccrine gland ducts, a fact that must be considered for the differential diagnosis between benign and malign lesions.…”

“…5,6 The dermoscopic pattern of parallel ridges is described as an accentuated pigmentation in the deep intermediate ridges ( crista profunda intermedia ), which acquire the same aspects of parallel ridges seen on glabrous skin. 3,5,7 According to the algorithm depicted by Saida, 1 acquired melanocytic lesions that present a parallel ridge dermoscopy pattern should be biopsied. However, this pattern has been recently reported on various benign lesions.…”