Juvenile melanocytic acral nevus: A comparative study between MANIAC and non‐MANIAC nevus and its clinicopathological characteristics

Abstract

Background Melanocytic acral nevi have a series of distinguishing features, including their location, patient age at onset, clinical progression, and histological findings. In particular, histopathological analysis often reveals a melanocytic acral nevus with intraepidermal ascent of cells (MANIAC nevus), which in some cases can be mistaken for atypia or malignancy. Aim This study describes the clinicopathological characteristics of acral nevi in patients under 18 years old and contrasts the clinical and histological features between MANIAC vs non‐MANIAC nevi. Methods This was a retrospective observational study, performed in our department in the decade between January 2007 and January 2017. We included patients younger than 18 years of age who were subjected to the removal of melanocytic acral nevi. Results A total of 70 patients were studied. 54.2% (38/70) were females and 45.8% (32/70) were males. With regard to the type of nevus, 34 were compound, 27 were junctional, and 9 were predominantly intradermal lesions. We identified a total of 41 MANIAC nevi and 29 non‐MANIAC nevi. Statistically significant differences between these two groups were identified in nevus size (larger in MANIAC) and the frequency of compound nevi (higher in the MANIAC group), but not in the remainder of the histological parameters studied.

Preferentially expressed antigen in melanoma and p16 expression in acral melanocytic neoplasms

“…In our cohort, poor circumscription was relatively more discerning, and asymmetry less discerning, between diagnostic groups compared to this report, although again pagetoid spread was not seen to be specific to melanoma. Indeed, pagetoid spread seen in “MANIAC” nevi (“Melanocytic Acral Nevus with Intraepidermal Ascent of Cells” 16 ) has been well characterized 17 . In our cohort, four patients were ≤18 years of age (Table S1; cases 1 [13‐year‐old female, benign acral nevus], 2 [15‐year‐old female, benign acral nevus], 14 [5‐year‐old male, acral junctional Spitz nevus], and 15 [10‐year‐old female, acral compound Spitz nevus]).…”

Melanocytic Acral Nevus With Intraepidermal Ascent of Cells: Five Cases

“…Dermoscopy patterns include parallel furrows reticular, fibrillar, and atypical, with the first being the most common. 1,2 Histologic analysis reveals melanocytes with mildly enlarged nuclei, variations in nuclear volume and architectural asymmetry, 3 unlike nevi in other locations. Given these characteristics, such lesions can easily be mistaken for malignant or atypical to unfamiliar eyes, leading to unnecessary diagnoses and interventions.…”

“…To the Editor: Acral melanocytic nevi are found in 4%-9% of the general population. 1 These lesions exhibit various clinical, dermoscopic, and microscopic characteristics, making them unique and deserving of greater attention. Dermoscopy patterns include parallel furrows reticular, fibrillar, and atypical, with the first being the most common.…”