先天性巨痣合并白癜风1例

患者男，34岁。因背部黑色斑块30余年、黑色斑块内及腹部等部位出现白斑2年余就诊。皮肤科检查可见腰背部大片状黑色斑块，上有黑色毛发；腹部及黑色斑块内外均可见大小不一的色素脱失斑，白斑区组织病理检查示黑素细胞损失。     

Clinical and dermoscopic features of small Reed nevus (<6 mm)

Background The differential diagnosis between Reed nevi and melanoma becomes more difficult if the lesion to analyse presents a small size, with a diameter of 6 mm or smaller. Many studies have reported various dermoscopic features of Reed nevi during their growth phases. In early stages of evolution, the lesions generally show a characteristic globular appearance typically found in childhood, followed by the so‐called starburst pattern. Objective The aim of the study was to identify the main dermoscopic features in small Reed nevi (<6 mm in size). Methods Using a computerized skin‐imaging database for melanoma prevention surgery at the Department of Dermatology of the University of Florence, 15 Reed nevi were selected among 103 small (<6 mm) melanocytic lesions consecutively excised. Images of small Reed nevi, independently blinded to histopathological diagnosis, were administered to a dermatologist expert in dermoscopy, who separately examined the clinical and the dermatoscopic images of small Reed nevi and evaluated their clinical and dermoscopic parameters. Results Analysis of the main dermoscopic patterns showed that 40% had a reticular pattern, 20% had a starburst pattern, 6.5% had a globular pattern, 6.5% had a homogeneous pattern and 27% had an atypical pattern. Conclusion We propose that small, early‐stage Reed nevus are not characterized by an evolution of growth patterns to a phenotype typical of larger lesions. We assume that the patterns are distributed in a linear manner between age groups, may all be present at the outset and thus are independent from the various stages of nevus development.     

先天性巨大色素痣并发白癜风1例

患者女，17岁。出生时即发现躯干有大片黑褐色素片，6年前开始全身出现散在色素脱失斑，苏木糖－伊红（HE）染色可见黑斑区真皮内散在和呈巢状分布的痣细胞，S－100和HMB45染色阳性。超微结构观察痣细胞内存在单个或复合黑素小体。白斑区皮扶表皮明显缺少黑素细胞。黑斑和白斑交界处未见朗格汉斯细胞。     

巨大先天性色素痣并发多发性脂肪瘤

报告1例巨大先天性色素痣并发多发性脂肪瘤。患者女,19岁。因躯干部出现黑色丘疹逐渐增大19年余就诊。体格检查：一般状况良好。颈部、躯干部、双上臂可见面积巨大的黑色斑片,融合成一体;表面粗糙,界限清楚;周围可见散在的卫星状皮损;背部可见10余个大小不等的皮下结节。组织病理检查示混合痣和脂肪瘤。     

掌黑癣误诊为交界痣一例

正掌黑癣(tinea nigra)是由威尼克何德霉引起的皮肤角质层的真菌感染,是一种浅表性暗色丝孢霉病。该病在我国报道比较少,临床诊疗过程中极易与色素痣、炎症后色素沉着、花斑糠疹、黑素瘤等混淆,导致误诊误治。为提高对掌黑癣的认识,现将我科初诊误诊为色素痣而行皮肤组织病理检查后明确诊断为掌黑癣1例,报道如下。临床资料患者,女,30岁,湖南人。因左手掌黑色斑疹半年于2016年5月31日就诊。患者半年前初发现左手掌邻近大鱼际处黄豆大黑斑,无自觉症状,未予诊治,黑斑逐渐缓慢扩大。患者平素体健,否认接触高盐化学物,无外伤史。     

SCALP syndrome: sebaceous nevus syndrome, CNS malformations, aplasia cutis congenita, limbal dermoid, and pigmented nevus (giant congenital melanocytic nevus) with neurocutaneous melanosis: a distinct syndromic entity

Nevus sebaceus syndrome (SNS) is a constellation of nevus sebaceus with extracutaneous findings, including the ophthalmologic nervous, and musculoskeletal systems. Didymosis aplasticosebacea is a recently described entity consisting of aplasia cutis congenita and nevus sebaceus, implying twin spotting (didymosis). We describe a neonate with a nevus sebaceus on the scalp and a limbal dermoid on her left eye. Contiguous with the nevus sebaceus was a giant congenital melanocytic nevus and numerous areas of membranous aplasia cutis congenita. We propose the acronym SCALP (nevus sebaceus, central nervous system malformations, aplasia cutis congenita, limbal dermoid, pigmented nevus) to summarize the unique features of this case and review the two similar cases in the literature.     

Verruciform xanthoma: report of three patients with comparative dermoscopic study

We report three cases of verruciform xanthoma (VX) in male patients aged 82, 88 and 39 years, respectively. The clinical appearance was of a mulberry‐like area consisting of small papillae, which is typical of and specific to VX, and the diagnosis were histologically confirmed in all cases. Dermoscopy revealed that each surface papilla contained linear or hairpin vessels, which were surrounded by a marginal whitish rim. These structures are thought to correspond to dilated vessels in dermal papillae and papillated acanthotic epidermis, respectively. Furthermore, observation under compression (similar to diascopy) revealed yellow dots and debris, reflecting lipid‐laden foam cells. In order to compare these findings with those of other disorders with similar findings, two patients with xanthogranuloma, six with sebaceous naevus, and three with senile sebaceous hyperplasia were examined. The dermoscopic findings in these patients were not similar to those of VX. Therefore, we believe that the above dermoscopic findings are specific to VX and could be helpful in diagnosis.     

Clinical, dermoscopic and histopathological evaluation of the Meyerson nevus: case report

Meyerson nevi occur whenever a rare focal and transitory eczematous eruption arises around melanocytic lesions. The same phenomenon has also been observed in non-melanocytic lesions as well. Herein we report the case of a 25 year old, male patient, who had noticed, two months before, the arising of a pruriginous and erithematous halo around two nevi localized on his abdomen. The lesions were found to be atypical on dermoscopic examination and he was submitted to surgical excision of both nevi. Histopathological examination revealed displastic compound melanocytic nevi, surrounded by intraepidermical vesicles and spongiosis. Present report suggests that Meyerson phenomenon does not seem to alter dermoscopic features of nevi.     

Pure apocrine nevus: a report of 4 cases

Apocrine nevus is a rare tumor composed of increased mature apocrine glands and ductal structures within a fibrous stroma, located predominantly in the reticular dermis. They have been reported in association with apocrine carcinoma, extramammary Paget disease, and syringocystadenoma papilliferum; less commonly a pure apocrine nevus is identified, unassociated with another apocrine proliferation. Clinically apocrine nevi may appear as solitary or multiple nodules or plaques on the scalp, presternal skin, though they are seen most commonly in the axillae. We describe 4 cases of pure apocrine nevus, all of which appeared clinically as painless or mildly tender skin-colored axillary masses, 2 of which were bilateral. In each case, the lesions appeared in adulthood, and patients denied knowledge of congenital or childhood presence. Patients denied pruritis, discharge, bleeding, or antecedent trauma. Grossly, the specimens consisted of subcutaneous, multicystic ill-defined nodules. Biopsy showed prominent apocrine glands composed of irregularly columnar luminal cells with eosinophilic cytoplasm arranged in a somewhat organoid pattern filling the reticular dermis and extending into the subcutaneous adipose tissue. The glandular luminal cells displayed decapitation secretion. There was a paucity of pilosebaceous units. In one case, the overlying epidermis was papillomatous. The deepest portion of one specimen had lactational change simulating a lactational adenoma. No atypia was seen in either the glandular structures or the stroma. The adjacent sebaceous and eccrine structures were normal. The histologic features and immunohistochemical profile in relation to other apocrine lesions will be reviewed.     

深部穿通性痣

报告2例深部穿通性痣.男、女患者各1例,年龄分别为8岁和50岁.临床上为单发的深蓝色结节.组织病理检查均表现为皮损呈楔形,界限清楚,底部较宽位于邻近表皮,其余部分从真皮上部沿毛囊、汗腺、血管和神经向下穿透真皮深部.高倍镜下,位于真皮深部的黑素细胞呈梭形,胞质丰富,内含黑素颗粒,并有异形性,但未见核有丝分裂象.免疫组化检查显示黑素细胞的胞质S-100蛋白和HMB-45均强阳性.符合深部穿通性痣的诊断.临床和组织病理上该病主要需与蓝痣和黑素瘤鉴别.     

Linear Cowden nevus: a new distinct epidermal nevus

Within the group of epidermal nevi, a so far nameless disorder is described under the term "linear Cowden nevus". This non-organoid epidermal nevus is caused by loss of heterozygosity, occurring at an early developmental stage in an embryo with a germline PTEN mutation, giving rise to Cowden disease. Hence, linear Cowden nevus can be categorized as a characteristic feature of type 2 segmental Cowden disease. Until now, several authors had mistaken this epidermal nevus as a manifestation of Proteus syndrome. The concept of linear Cowden nevus implies that Proteus syndrome is by no means caused by PTEN mutations. As a clinical difference, linear Cowden nevus is markedly papillomatous and thick, whereas linear Proteus nevus tends to be rather flat. Moreover, the spectrum of possibly associated cutaneous or extracutaneous anomalies differs in the two types of nevi. In conclusion, linear Cowden nevus, that may also be called "linear PTEN nevus", represents a distinct clinicogenetic entity.     

Regressing eruptive disseminated pigmented Spitz (Reed) nevi in a young adult

Eruptive disseminated Spitz nevi is a rare clinical presentation that features an abrupt widespread eruption of Spitz nevi. Spontaneous regression of these nevi has been rarely reported in previous literature. The authors of the present study report the case of a 30-year-old man who presented eruptive disseminated Spitz nevi that appeared within a week and started regression in the following years.     

The pigmented spindle cell tumor of Reed (author's transl)

The pigmented spindle cell tumour (PSCT) of Reed et al. is described by means of 28 own observations. The possibilities for histological definition and the differential diagnosis is other tumours are discussed.