罕见口腔黏膜皮内痣1例

报告1例口腔黏膜皮内痣。患者男,15岁。口腔黏膜肿物15年,近3个月来肿物增长较快。皮损组织病理示:真皮内可见大量呈巢状痣细胞,其内见较多黑素颗粒,细胞成熟未见核分裂相。诊断:口腔黏膜皮内痣。行右下前牙拔除+肿物切除+局部牙槽骨去除术,并予抗感染治疗,创面愈合良好,无复发。     

The Vascular Space-like Structure in Melanocytic Nevus Is Not an Injection Artifact: Report of a Case and an Experimental Study

Melanocytic nevi may microscopically associate with clefts or slits of the nests resembling lymphatic or vascular spaces. This unique histologic feature has been known as an artifact of injection or tissue-processing. We present a case of melanocytic nevus with a prominent vascular space-like structure. We also studied whether intralesional injection of local anesthetic could reproduce similar histologic findings. A 45-year-old Japanese female visited us with a solitary, brownish papule on the chest. Histology revealed numerous nests composed of round to oval-shaped nevus cells throughout the entire dermis. In the mid-dermis, nevus cells were lined up in a layer anastomosing and forming a vascular space-like structure. These nevus cells were uniformly stained with vimentin and S100 protein but not with factor VIII-related antigen. They were also positively immunoreactive with anti-type IV collagen and anti-fibronectin. There were no significant differences in staining intensity in the nevus cells between the solid portion and the vascular space-like structure. In the experimental study, eight melanocytic nevi were removed under local anesthesia. The local anesthetic solution was then injected into the excised nevus. Intralesional injection of a considerable volume of local anesthetic was capable of causing slits or clefts of the nests and dermal edema; however, it failed to reproduce a vascular space-like structure similar to that in the present case. These findings suggest that a vascular space-like structure in melanocytic nevus is not caused by the injection alone. Some other factor(s) may play a major role in the development of such structures in melanocytic nevus.     

Osteo-nevus of Nanta: a case report and review of the Japanese literature

We reported a 58-year-old Japanese male with osteo-nevus of Nanta on his right cheek. Histological examination revealed nests of nevus cells throughout the entire dermis. Just beneath the nevus in the lower dermis, several basophilic oval-shaped membranous structures were positive with Kossa stain. No inflammatory infiltrate or foreign-body granuloma were seen. We reviewed 28 cases of osteo-nevus of Nanta reported in the Japanese literature and discussed the pathogenesis of ossification in the lesions of nevus cell nevi.     

Development of Halo Nevus Around Nevus Spilus as a Central Nevus,and the Concurrent Vitiligo

Halo nevus is a benign melanocytic nevus that is surrounded by a hypopigmented zone. The most frequent association with halo nevus is vitiligo, and this also appears in nearby regions, as well as at other remote sites. Although the mechanism for developing the depigmentation around nevus spilus is uncertain an immunologic process may be responsible for the finding of inflammatory infiltrates of the upper dermis in the depigmented lesions. We report here on a 13-year-old boy who showed a depigmented zone around a nevus spilus on the right side of his neck with simultaneous vitiligo lesions on the face.     

A Case Report on the Dermoscopic Features of Spark's Nevus

Spark''s nevus is a compound word composed of Spitz nevus and Clark''s nevus. It is one of the combined melanocytic nevi which is more common in female and usually presents as a sharp circumscribed hyperpigmented macule on the lower extremities. On histopathologic findings, both cytologic features of Spitz nevus characterized as large spindle or epithelioid melanocytes containing large nuclei with abundant cytoplasm, and architecture of Clark''s nevus characterized as elongation of rete ridges, bridging of the nests, concentric and lamellar fibrosis can be seen. A 24-year-old female presented with an asymptomatic, solitary, dark-brown-colored papule surrounded by brownish patch that looked similar to dysplastic nevus or malignant melanoma on the buttock. On dermoscopic examination, it showed brown-to-black globules, diffuse homogenous pigmentation with blue-white structures, and a surrounding brownish reticular pattern that faded away. On histopathologic findings, overall asymmetrical structure, epithelioid large melanocytes containing large nuclei with abundant cytoplasm, and Kamino body were seen in the central portion. Also, lentiginous hyperplasia, bridging of the nests composed of melanocytes containing foamy cytoplasm, concentric and lamellar fibrosis along with the elongation of rete ridge, and perivascular lymphocytic infiltration were seen in the peripheral portion. The diagnosis of Spark''s nevus was made. Following its definition, this combined nevus is diagnosed histopathologically, but the clinicodermoscopic features have not been well described. Herein, we report a case of Spark''s nevus in which dermoscopy was helpful for differentiating it from malignant melanoma.     

Transforming growth factor beta and connective tissue growth factor are involved in the evolution of nevus of Nanta

We report a 59-year-old Japanese male with nevus of Nanta on the face. Histological examination revealed a nest of nevus cells in the dermis and ossification beneath the nevus. Positive staining for transforming growth factor-beta and connective tissue growth factor suggested the involvement of these growth factors in the ossification of nevus of Nanta.     

Nevus psiloliparus: report of two nonsyndromic cases

A diagnosis of nevus psiloliparus was made both clinically and histopathologically in two otherwise healthy girls, one being 4 years and the other one being 1 year old. A congenital hairless patch with a round or oblong shape and a soft surface was noted on the scalp. In one case the lesion was yellowish and flat, whereas in the other case it was skin colored and somewhat elevated. In both cases, histopathological examination showed the absence of mature hair follicles and the presence of undeveloped follicular structures as well as orphaned arrector pili muscles in the dermis. As a new histopathological feature of this type of nevus, we found arrested anlagen of hair bulbs in both cases. The fatty tissue was abundant and also involved, in the form of aberrant lobules, the lower portion of the dermis. Clinical examination did not show any associated extracutaneous abnormality, and during a follow-up period of 2 years in either case, respectively, the children developed without any complication. Although neurological abnormalities could not be excluded by imaging techniques, such extracutaneous involvement is highly unlikely because the nevi psilolipari were of rather limited size. When clinicians and dermatohistopathologists have become familiar with this new entity, they will most likely recognize it as a nonsyndromic skin disorder more often than as a cutaneous sign of encephalocraniocutaneous lipomatosis.     

Disseminated Nevus Anelasticus

A 23-year-old man presented with a diffuse and fine wrinkling of the skin of his back and trunk. Skin lesions had first appeared about 5 years earlier and resulted from coalescing of multiple, flat, pinkish-red papules, a few millimeters in diameter. A diagnosis of widespread cutaneous elastic hamartoma was made. Histology revealed a focal disappearance of elastic fibers within circumscribed areas of the dermis. The pattern of the dermal collagen and reticulin was normal. No concomitant changes in the bone density were recognized by x-ray, excluding the Buschke-Ollendorff syndrome. Therefore, we call this case "disseminated nevus anelasticus."     

Systematized Epidermal Nevus with Profuse Papillomatous Flexural Lesions

A case of systematized epidermal nevus with profuse papillomatous flexural lesions is reported for its striking morphologic features and unusual variations in histopathology at different sites.     

A Combination of Speckled Lentiginous Nevus with Patch-type Blue Nevus

A peculiar case of “nevus on nevus” was reported. A 67-year-old man had had a pigmented lesion in the left hypochondrial area since birth. The clinicopathologic findings of the pigmented lesion revealed a combination of speckled lentiginous nevus and patch-type blue nevus. This case of “nevus on nevus” is not described under the term of combined nevus as is current in the literature; it was considered to be a subtype of the type II atypical blue nevus described by Kawamura.     

Placental Nevus Cells Associated with Giant Congenital Pigmented Nevi

Abstract: We present an infant born with a giant congenital pigmented nevus. The placenta revealed nests of nevus cells in the chorionic villi on the fetal side of circulation. These findings are consistent with four reports in the literature to date.     

Nevus anelasticus: how should such lesions be classified?

Nevus anelasticus represents a rare entity that is most commonly classified as a connective tissue nevus. It typically presents before 20 years of age with asymmetrically distributed white‐to‐skin‐toned or pink‐to‐red papules or plaques on the trunk and upper extremities. The lesion is defined histopathologically by the absence or degeneration of elastic fibers in the dermis. We report the case of a healthy 17‐year‐old female who presented with an asymptomatic slowly progressive plaque on the right inferior areola. Histopathologic examination showed the absence of elastic fibers in the papillary and upper reticular dermis and fragmented elastic tissue fibers in the deep reticular dermis. Although there is ongoing controversy regarding the nosology of this uncommon disorder, we propose that it is a distinct entity based on its histopathologic and clinical features.     

Agminated Fibroblastic Conective Tissue Nevus: A New Clinical Presentation

Connective tissue nevi are benign hamartomatous lesions in which one or several of the components of the dermis (collagen, elastin, glicosaminoglycans) show predominance or depletion. Recently, de Feraudy et al broadened the spectrum of connective tissue nevus, describing fibroblastic connective tissue nevus (FCTN), which is characterized by proliferation of CD34⁺ cells of fibroblastic and myofibroblastic lineage. Only solitary papules and nodules have been described. We present the first case of FCTN with multiple agminated lesions on the leg of an infant and the difficulties encountered in the differential diagnosis with dermatofibrosarcoma protuberans.     

15例甲下色素痣临床及组织病理学分析

目的:探讨甲下色素痣的临床及组织病理学特点.方法:回顾分析西京医院全军皮肤病研究所2003-2009年诊断的15例甲下色素痣患者的临床及组织病理学特点.结果:15例患者年龄均<25岁,其中男6例.女9例.发生于指甲14例,发生于趾甲1例,各指(趾)间病甲分布无明显差异.12例表现为界限清楚,颜色均一的甲黑线,3例表现为全甲黑变.有1例患者为复发性甲色素痣.组织病理资料显示14例患者表现为交界痣,1例为混合痣,未发现单纯皮内痣患者.甲色素痣表现为以甲母质为中心的黑素细胞增生,细胞呈单个分布或聚集成巢,多位于近基底层部位.混合痣真皮内可见少量界限清楚的细胞巢.色素痣细胞形态均一,细胞核小,无典型核分裂象,树状突不明显,多产生较细腻的色素颗粒.结论:甲下色素痣是发生在甲母质及甲板部位的良性色素痣,多见于儿童和青少年,临床以颜色均一、界限清楚的甲黑线或弥漫性黑甲为主要表现.其组织病理特征多为交界痣.     

Pigmented Trichoblastoma Arising from the Nevus Sebaceous: A Rare Case in Korea

Trichoblastoma is occasionally observed in association with a pre-existing nevus sebaceous in the Korean literature. However, there has been no report on the pigmented type. Herein, we report the first Korean case of a pigmented trichoblastoma arising from the nevus sebaceous on the forehead. A 28-year-old male presented with a dark nodular lesion within a yellowish plaque on the forehead. The surrounding yellowish plaque on the forehead had existed since birth. The central, dark-pigmented nodule began to appear three years ago and enlarged gradually. Histopathologic findings of central pigmented lesion showed heavy melanin deposits within and around the tumor nests. Complete excision was made as treatment.     

皮脂腺痣并发乳头状汗管囊腺瘤及管状乳头状顶泌汗腺腺瘤

报告1例皮脂腺痣并发乳头状汗管囊腺瘤及管状乳头状顶泌汗腺腺瘤.患者女,26岁.因右侧头皮黄色无毛斑块26年就诊.体格检查示右侧头皮黄色无毛斑块,边界清楚,表面粗糙,局部糜烂渗液.组织病理检查示表皮疣状增生,皮脂腺和顶泌汗腺增生.一部分顶泌汗腺与表皮相连,形成乳头状突起,其间质中有较多浆细胞浸润;另一部分顶泌汗腺位于真皮深部,不与表皮相连,形成较多管腔样结构,管腔内见顶泌汗腺呈乳头状突入管腔.结合临床资料及组织病理学改变,本病为1例罕见的皮脂腺痣并发乳头状汗管囊腺瘤及管状乳头状顶泌汗腺腺瘤.     

Nevus of Striated Muscle: A New Clinicopathologic Entity

A 3‐month‐old boy presented with a congenital atrophic plaque on his right palm. On histopathologic examination, bundles of mature striated muscle were noted replacing the subcutis and extending into the dermis, without any other mesenchymal component seen. We have not been able to find a similar previously reported case. We propose the name nevus of striated muscle for this congenital, well‐circumscribed cutaneous lesion composed exclusively of mature skeletal muscle.     

Congenital pilar and smooth muscle nevus

A case of congenital pilar and smooth muscle nevus (CPSMN) is reported. CPSMN is a distinct clinical and histologic entity characterized by prominent vellus hairs accompanying a proliferation of smooth muscle within the reticular dermis. Plaquelike elevation and mild hyperpigmentation are variable features of this unusual organoid nevus.     

Nevus Comedonicus Bilateralis Et Verruciformis

A case of nevus comedonicus is described which was bilateral, more prominent on the right side, worse on the buttocks with unusual verrucous nodules on the right helix, knee and elbows, and affecting the palms and soles. This patient would appear to have been the most seriously afflicted of the 130 reported cases. In addition to the more comedo-like lesions on the trunk, a unique feature was the gradual development of verrucous nodules on the helix of the right ear, knee, hand and elbows. The pathologic changes on the nevus comedonicus on the trunk showed the epidermis to be invaginated, in some instances suggesting a tubular-like quality, with a dilated orifice containing keratin protruding above the surface. Sebaceous glands and hair shaft were absent. The pathologic changes of the verrucous nodule could be described as a more severe form of nevus comedonicus with folding and involution of the epidermis forming large crypts and cysts filled with keratin. Lesions were generally more severe in areas of pressure, which might explain the production of verrucous nodules.     

The role of E-cadherin in nevogenesis: an experimental study using epidermal reconstructs

BACKGROUND: In the development of congenital nevi, how nevus cells migrate in the dermis remains unclear. As shown in an earlier study designed to investigate Unna's Abtropfung hypothesis, dermal invasion does not occur when nevus cells are seeded on epidermal reconstructs. In melanoma, the decrease of E-cadherin expression is associated with the dermal invasion of melanoma cells. OBJECTIVE: To study the expression of E-cadherin in dermal-cultured nevus cells from congenital nevi and its relevance to explain the absence of dermal invasion noted in epidermis reconstructed with cultured nevus cells. METHODS: Comparison of the immunohistochemical expression pattern of E-cadherin in congenital nevi in vivo and after culture in monolayers and in a three-dimensional system. RESULTS: E-cadherin was not expressed in vivo by dermal nevus cells, either isolated or in nests. However, in monolayer cultures, dermal nevus cells expressed E-cadherin. When these cells were used in reconstructed epidermis, nevus cells did not invade the dermis and they expressed E-cadherin when isolated and just weakly or not when grouped in junctional nests. CONCLUSIONS: The absence of dermal invasion of nevus cells could be due to the expression of E-cadherin in these cells in reconstructed epidermis. Our experiments suggest, a restoration of the control of keratinocytes, that nevus cells escape in the dermal compartment.