Melanocytic aggregates with unique morphology associated with regression of basal cell carcinoma

Jackson, Christopher R.; Sriharan, Aravindhan; Momtahen, Shabnam; Seidel, Gregory D.; Felty, Cameron C; Ruby, Kristen N; Yan, Shaofeng

doi:10.1111/cup.13608

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…Pseudomelanocytic nests have been described in various interface processes, including lichen planus, 5 lichen planus pigmentosus, 2,4 lupus erythematosus, 6,7 fixed drug eruption, 3 and phototoxic reactions 2 . This phenomenon has also been described in solitary lesions such as pigmented lichenoid keratosis 2 and basal cell carcinoma with regression 8 . Given that 6.7% of melanomas are associated with a lichenoid tissue reaction, 9 pseudomelanocytic nests can be a potential diagnostic pitfall for inflamed or regressed melanoma in situ (MIS).…”

Section: Introductionmentioning

confidence: 98%

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Lichenoid dermatoses with pseudomelanocytic nests vs inflamed melanoma in situ: A comparative study

Panse

McNiff

2021

J Cutan Pathol

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Aims Pseudomelanocytic nests or “pseudonests” arising in lichenoid dermatoses can be a diagnostic pitfall for melanoma in situ (MIS), especially on sun‐damaged skin. We sought to evaluate histopathological features that may be helpful in distinguishing this benign process from inflamed MIS. Methods Ten biopsy specimens containing pseudomelanocytic nests within lichenoid dermatoses and twenty cases of inflamed MIS were retrospectively reviewed. Cases with pseudomelanocytic nests represented either a rash (n = 6) or a discrete non‐melanocytic lesion, such as lichenoid keratosis (n = 4). Results All cases with pseudomelanocytic nests showed nests of microphthalmia‐associated transcription factor‐positive cells at the dermoepidermal junction (DEJ) with interface changes and lichenoid inflammation. Pagetoid scatter, confluence of solitary melanocytes at the DEJ and significant cytologic atypia was not seen in any of these cases. In contrast, all cases of inflamed MIS demonstrated confluence of single melanocytes at the DEJ with cytologic atypia (P < 0.001) and 18/20 cases showed pagetoid scatter of melanocytes (P = 0.001). Conclusions Our results show that, of the different histopathological features assessed, confluent growth and pagetoid scatter of atypical melanocytes were seen in most cases of inflamed MIS but were absent in all cases with pseudomelanocytic nests. Therefore, in addition to clinicopathological correlation, these features may be useful in differentiating pseudomelanocytic nests arising in lichenoid dermatoses from inflamed MIS.

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Section: Introductionmentioning

confidence: 98%

“…2 This phenomenon has also been described in solitary lesions such as pigmented lichenoid keratosis 2 and basal cell carcinoma with regression. 8 Given that 6.7% of melanomas are associated with a lichenoid tissue reaction, 9 pseudomelanocytic nests can be a potential diagnostic pitfall for inflamed or regressed melanoma in situ (MIS).…”

Section: Introductionmentioning

confidence: 99%

Lichenoid dermatoses with pseudomelanocytic nests vs inflamed melanoma in situ: A comparative study

Panse

McNiff

2021

J Cutan Pathol

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“…Furthermore, many studies demonstrated that melanocytes in pBCCs do not have any distinct configuration and theydo not organize in clusters, a feature that is more likely to be seen in melanoma 27,31. Jackson et al32 in a case series of 14 spontaneously regressed BCC identified melanocytic aggregates associated with BCC at different stages of regression. They speculated that in BCC's regression, mostly in pBCCs, the immune response may target the basal cells and spare the melanocytes, allowing them to organize in nest like structures or as scattered solitary melanocytes.…”

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confidence: 99%

Efficacy of Vismodegib in pigmented basal cell carcinoma: Appearances are deceiving

Raimondo

Mazzeo

Prete

et al. 2020

Dermatologic Therapy

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Basal cell carcinoma (BCC) is the most common skin cancer in humans. Pigmented basal cell carcinoma (pBCC) is a rare variant of BCC. Vismodegib, was the first drug to be approved for the treatment of locally advanced (laBCCs) or metastatic basal cell carcinoma. The aim of this study was to evaluate the efficacy of Vismodegib in patients with pBCCs. We retrospectively analyzed patients receiving Vismodegib as treatment for laBCCs presenting also various pBCCs. After 6 months of treatment, we performed excisional biopsies of pBCCs, that apparently at clinical and dermoscopic assessment did not respond to therapy. A total of nine patients were assessed. After 6 months of treatment, locally advanced target BCCs showed complete remission in four out of nine patients (44.4%), four patients (44.4%) were considered in partial remission and one patient (11%) showed no response to treatment. On the contrary, all the pBCCs showed both clinically and dermoscopically resistance to treatment. Therefore, clinically persistent pBCCs were surgically removed in three patients. Histology showed a complete elimination of the neoplastic cells together with features of previous regression. Our findings indicate that the efficacy of Vismodegib is higher than that documented by clinical or even dermatoscopic observation alone.

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Laser management for congenital dermal melanocytosis

Ponomarev¹,

Шакина²

2020

RPJ

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Congenital dermal melanocytosis (CDM) is a malformation of the dermis caused by antenatal impairment of melanogenesis. There are considered data on the epidemiology, history of the study, the characteristics of the pathogenesis and clinical picture of CDM. Data on the efficacy and side effects of treatment of CDM with ruby, alexandrite and neodymium laser in children and adults are compared. The effectiveness of laser treatment for CDM is closely related to the value of the integral absorption of radiation by targeted photothermophores of the epidermis and dermis: melanin, oxyhemoglobin and reduced hemoglobin. The safety of laser exposure is determined by its selectivity, which directly depends on the ratio between the absorption of radiation by the main target photothermophores and water. For the first time, integral indices of the absorption of laser radiation in the pathological focus area by the main photothermophores of the epidermis and dermis (oxyhemoglobin, reduced hemoglobin, as well as the melanin content and localization of ectopic melanocytes in the reticular layer of the dermis) and water are presented. In the CDM involved area, the integrated coefficients of absorption by the main target photothermophores of radiation with a wavelength of 511 nm and 578 nm were shown to be much higher, and the absorption by water is much lower than for radiation with a wavelength of more than 600 nm generated by a ruby, alexandrite or neodymium laser. The described pathogenetic features of laser skin biophotonics upon exposure of the CDM region to the radiation with a wavelength of more than 600 nm increases the risk of the development of such characteristic side effects as hyperpigmentation, deterioration of the collagen structure of the dermis with subsequent formation of scars in the postradiated area. To ensure the complete elimination of ectopic melanocytes and minimize the risk of side effects during laser surgical treatment of CMD area, it is advisable to use the two-wavelengths radiation generated by the copper vapor laser: with a wavelength that is maximally absorbed by melanin (511 nm) and with a wavelength with high absorption of both oxyhemoglobin and hemoglobin (578 nm), but with negligible absorption by water.

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Melanocytic aggregates with unique morphology associated with regression of basal cell carcinoma

Cited by 3 publications

References 23 publications

Lichenoid dermatoses with pseudomelanocytic nests vs inflamed melanoma in situ: A comparative study

Lichenoid dermatoses with pseudomelanocytic nests vs inflamed melanoma in situ: A comparative study

Efficacy of Vismodegib in pigmented basal cell carcinoma: Appearances are deceiving

Laser management for congenital dermal melanocytosis

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